Astbury Laura, Pinnington Donna M, Milgrom Jeannette, Bei Bei
Faculty of Medicine, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Nursing and Health Sciences, Monash University, Victoria, Australia.
Faculty of Medicine, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Nursing and Health Sciences, Monash University, Victoria, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Victoria, Australia.
J Affect Disord. 2025 Feb 1;370:1-8. doi: 10.1016/j.jad.2024.10.080. Epub 2024 Oct 24.
The understanding of long-term depression and anxiety trajectories across the perinatal periods is lacking. This longitudinal study investigated the change trajectories of both depressive and anxiety symptoms, as well as the associations of their trajectories over five years. The study included nulliparous participants (N = 163, M = 33.47, SD = 3.53) with self-reported depressive and anxiety symptoms collected via questionnaires at 30- and 35 weeks' gestation, 1.5, 3, 6, 12, 24, and 60 months postpartum. Data were analysed using structural equation latent growth modelling with and without covariates. Symptoms of depression increased significantly during pregnancy (p < .001), and both depression and anxiety symptoms increased during postpartum (p-values<.001). A previous mental health history was significantly associated with greater depressive symptomology (p = .001), and White individuals (compared to non-White) tended to have greater depression and anxiety symptoms during pregnancy (p-values<.05). At 30- and 35-weeks' gestation, 6 weeks postpartum, 3, 6, 12, 24 months, and 5 years postpartum 2.5 %, 2.0 %, 4.6 %, 4.0 %, 7.3 %, 5.6 %, 3.5 % and 8.0 % of participants had clinically significant depressive symptoms and 6.1 %, 8.5 %, 7.1 %, 12.0 %, 11.9 %, 8.1 %, 7.9 %, and 28 % had clinically significant anxiety symptoms. This study highlights the need to assess both depression and anxiety in perinatal care, and to identify individuals who may require intervention.
目前尚缺乏对围产期长期抑郁和焦虑轨迹的了解。这项纵向研究调查了抑郁和焦虑症状的变化轨迹，以及它们在五年内的轨迹关联。该研究纳入了未生育的参与者（N = 163，M = 33.47，SD = 3.53），通过问卷调查在妊娠30周和35周、产后1.5个月、3个月、6个月、12个月、24个月和60个月收集自我报告的抑郁和焦虑症状。使用带有和不带有协变量的结构方程潜在增长模型对数据进行分析。抑郁症状在孕期显著增加（p <.001），产后抑郁和焦虑症状均增加（p值<.001）。既往心理健康史与更严重的抑郁症状显著相关（p =.001），白人个体（与非白人相比）在孕期往往有更严重的抑郁和焦虑症状（p值<.05）。在妊娠30周和35周、产后6周、3个月、6个月、12个月、24个月以及产后5年，分别有2.5%、2.0%、4.6%、4.0%、7.3%、5.6%、3.5%和8.0%的参与者有临床显著的抑郁症状，6.1%、8.5%、7.1%、12.0%、11.9%、8.1%、7.9%和28%有临床显著的焦虑症状。这项研究强调了在围产期护理中评估抑郁和焦虑以及识别可能需要干预的个体的必要性。
