BGI Research, Shenzhen, 518083, China; China National GeneBank, BGI-Shenzhen, Shenzhen, 518210, China.
Tianjin Women's and Children's Health Center, Tianjin, 300070, China.
J Affect Disord. 2024 Dec 1;366:411-422. doi: 10.1016/j.jad.2024.08.122. Epub 2024 Aug 30.
Antenatal mental disorders are associated with maternal and fetal adverse events. Previous studies have been focused on the postpartum period, rather than pregnancy, yet the association of risk factors with prenatal depression and anxiety through pregnancy has been rarely reported. This study aimed to identify the risk factors of prenatal depression and anxiety, and access their potential roles in developing mental disorders during pregnancy.
This is a prospective study in 6470 participants from the Tianjin Birth Cohort in China (TJBC). The degree of prenatal depression and anxiety was evaluated using a questionnaire of Self-Rating Depression scale (SDS) and Self-Rating Anxiety Scale (SAS), which was given to pregnant women at 15-27 (Stage-2), and 28-41 (Stage-3) gestational weeks. The questionnaire also collected demographic, personal, and lifestyle information. The association of different factors with SDS/SAS score was examined by logistic regression analysis.
We observed an overall depression rate of 12.4 % and an overall anxiety rate of 7.7 % during pregnancy in the TJBC. In the Stage-2, the depression rate was 14.5 % and the anxiety rate was 9.5 %. In the Stage-3, the depression rate dropped to 9.7 % while the anxiety rate dropped to 5.3 %. With univariate analysis, we found that age, education, social support, marriage satisfaction, secondhand smoke (SHS), sleeping time and stress were common factors of prenatal mental health. Working status, family income, gravidity, smoking, electronic using, recreational activities were associated with depression risk, whereas BMI, disease history, changing eating habits, and feeding animal were associated with anxiety risk. Using logistic regression, we found that low education level, low social support, low marriage satisfaction, thyroid disfunction, Stage-2(second trimester), and stress were related to prenatal mental health.
The prevalence anxiety and depression in Tianjin is normal as national level. Age appropriateness, a good education level, sufficient social support, marital satisfaction, normal thyroid function, and absence of stress are associated with relieving depression and anxiety during gestation. However, due to individual difference, expectant mothers should seek professional support and guidance to address their mental health needs during gestation.
产前精神障碍与母婴不良事件有关。既往研究多集中于产后时期，而非孕期，但目前很少有研究报道产前抑郁和焦虑相关危险因素与孕期的关系。本研究旨在确定产前抑郁和焦虑的危险因素，并探讨其在孕期精神障碍发展中的潜在作用。
本研究为中国天津出生队列（TJBC）的一项前瞻性研究，共纳入 6470 名研究对象。在妊娠 15-27 周（第 2 阶段）和 28-41 周（第 3 阶段）时，使用自评抑郁量表（SDS）和自评焦虑量表（SAS）评估孕妇的产前抑郁和焦虑程度。问卷还收集了人口统计学、个人和生活方式信息。采用 logistic 回归分析不同因素与 SDS/SAS 评分的相关性。
TJBC 研究中，孕妇在整个孕期的抑郁发生率为 12.4%，焦虑发生率为 7.7%。第 2 阶段的抑郁发生率为 14.5%，焦虑发生率为 9.5%；第 3 阶段的抑郁发生率降至 9.7%，焦虑发生率降至 5.3%。单因素分析发现，年龄、教育程度、社会支持、婚姻满意度、二手烟（SHS）、睡眠时间和压力是影响孕妇心理健康的常见因素。工作状态、家庭收入、孕次、吸烟、电子设备使用、娱乐活动与抑郁风险相关，而 BMI、疾病史、饮食习惯改变和饲养宠物与焦虑风险相关。Logistic 回归分析发现，低教育程度、低社会支持、低婚姻满意度、甲状腺功能障碍、第 2 阶段（中期妊娠）和压力与产前心理健康相关。
天津的产前焦虑和抑郁发生率与全国水平相当。年龄适宜、良好的教育程度、充足的社会支持、婚姻满意度、甲状腺功能正常和无压力与缓解孕期抑郁和焦虑有关。然而，由于个体差异，孕妇应寻求专业支持和指导，以满足其孕期的心理健康需求。
