Research Unit of Child and Adolescent Psychiatry, Department of Clinical Research, University of Southern Denmark, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark; Research unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
J Affect Disord. 2024 Dec 1;366:91-97. doi: 10.1016/j.jad.2024.08.167. Epub 2024 Aug 24.
Little is known about the time trends of postpartum depression (PPD) and whether they differ from time trends of depression among women in general.
Using Danish health registers, we identified a postpartum population from all women who had a liveborn child from 2000-2022. We sampled a background population by matching five women for each delivery on age and date of childbirth. Depression and PPD were measured as incident depression diagnosis or redeemed antidepressant prescription within 180 days from childbirth/matching. We described incidence rates from 2000-2022 using Poisson regression with a restricted cubic spline.
The study population included 1,133,947 postpartum women (669,101 unique), matched to 5,669,735 women (1,165,505 unique). Overall IR per 10,000 person-years of diagnoses was 34.3 (95% CI: 32.8-35.9) for PPD and 18.9 (95% CI: 18.3-19.4) for depression. Both IRs increased similarly over time in the main analyses, but more pronounced for PPD in primiparous and older mothers. Correspondingly, IR for prescriptions was 135.7 (95% CI: 132.7-138.8) for PPD and 209.8 (95% CI: 208.1-211.5) for depression, and both groups had fluctuating time trends.
Depression measures were based on women who actively sought and received treatment, expectedly underestimating true disease incidence.
Incidence rates of PPD and depression diagnoses increased over time, especially for PPD among primiparous and older mothers. These findings could suggest either increased vulnerability or increased awareness and detection over time in these groups. Fluctuating trends overserved from prescriptions could likely be driven by external factors and not a reflection of disease trends.
关于产后抑郁症（PPD）的时间趋势知之甚少，且其是否与一般女性的抑郁时间趋势不同也不得而知。
我们利用丹麦健康登记系统，从 2000 年至 2022 年所有活产儿的母亲中确定了一个产后人群。我们通过在分娩日期和年龄上与每个分娩匹配 5 名女性，为每个分娩匹配了一个背景人群。在分娩/匹配后 180 天内，我们将抑郁诊断或抗抑郁药物处方的新发情况作为抑郁发生的衡量指标。我们使用泊松回归和限制三次样条描述了 2000 年至 2022 年的发病率。
研究人群包括 1133947 名产后妇女（669101 人），匹配了 5669735 名妇女（1165505 人）。每 10000 人年的诊断人数中，PPD 的发病率为 34.3（95%可信区间：32.8-35.9），抑郁的发病率为 18.9（95%可信区间：18.3-19.4）。在主要分析中，这两种发病率均随时间呈相似趋势上升，但初产妇和年龄较大的母亲中 PPD 的上升趋势更为明显。相应地，PPD 的处方发病率为 135.7（95%可信区间：132.7-138.8），抑郁的处方发病率为 209.8（95%可信区间：208.1-211.5），且这两个组的发病率都有波动。
抑郁的衡量标准基于主动寻求和接受治疗的女性，预计会低估真实的疾病发病率。
PPD 和抑郁诊断的发病率随时间呈上升趋势，尤其是初产妇和年龄较大的母亲中 PPD 的发病率上升更为明显。这些发现可能表明这些群体的易感性增加，或者随着时间的推移，对疾病的认识和检测有所提高。从处方中观察到的波动趋势可能主要是由外部因素驱动的，而不是疾病趋势的反映。
