产后2个月时焦虑症状的患病率及相关因素，来自2021年法国全国前瞻性队列研究的结果。
Prevalence of anxiety symptoms and associated factors at 2 months postpartum, results from a 2021 French national prospective cohort study.
作者信息
Doncarli Alexandra, Demiguel Virginie, Le Ray Camille, Deneux-Tharaux Catherine, Lebreton Elodie, Apter Gisèle, Boudet-Berquier Julie, Crenn-Hebert Catherine, Vacheron Marie-Noëlle, Regnault Nolwenn, Tebeka Sarah
机构信息
Santé publique France, the national public health agency, Saint-Maurice, France.
Université Paris Cité, Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), CRESS U1153, INSERM, INRAE; Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, FHU Prema, Paris, France.
出版信息
Eur Psychiatry. 2024 Dec 27;67(1):e89. doi: 10.1192/j.eurpsy.2024.1799.
BACKGROUND
Postpartum anxiety (PPA) symptoms have harmful effects on child development and mother-infant interactions. Accordingly, in-depth knowledge of associated risk factors is crucial for prevention policies. This study aimed to estimate PPA symptom prevalence at 2 months and to identify associated risk factors in a representative sample of all women who gave birth in France in 2021, and in two subgroups: women with no postpartum depression (PPD) symptoms, and those with no history of mental health care.
METHODS
Among the 12,723 women included in the representative French national perinatal survey 2021ENP, 7,133 completed the Edinburgh Postnatal Depression Scale (EPDS) self-administered questionnaire - including three anxiety-specific items (EPDS-3A) - at 2 months postpartum. We estimated the adjusted prevalence ratios (aPR) of PPA symptoms using Poisson regression models with robust variance.
RESULTS
PPA symptom prevalence at 2 months was 27.6% (95% CI [26.5-28.8]). Associated risk factors were: age ≤ 34 years (maximum aPR = 1.38 [1.22-1.58] obtained for persons aged 25-29 years vs. 35-39 years), poorer health literacy (1.15 [1.07-1.23]), a history of medical termination of pregnancy (1.32 [1.05-1.68]), psychological (1.31 [1.17-1.47]) or psychiatric (1.42 [1.24-1.63]) care history since adolescence, nulliparity (1.23 [1.12-1.35]), no weight gain or loss (1.29 [1.03-1.61] vs. 9-15 kg gain) or gain ≥23 kg (1.20 [1.00-1.43]) during pregnancy, ≥3 pregnancy-related emergency consultations (1.16 [1.03-1.31] vs. none), poor/good support during pregnancy, (1.16 [1.00-1.34] and 1.15 [1.05-1.26], respectively, vs. very good), sadness (1.52 [1.36-1.69]), anhedonia (1.48 [1.27-1.72]), or both (1.99 [1.79-2.21]) during pregnancy, not at all/not very satisfied with pain management during childbirth (1.16 [1.01-1.32] vs. quite/very satisfied). Similar risk factors were found in the 'no PPD symptoms' and 'no history of mental health care' subgroups.
CONCLUSIONS
Estimated PPA symptom prevalence at 2 months in our study sample was 27.6%. The risk factors we identified may guide future prevention policies.
背景
产后焦虑（PPA）症状对儿童发育和母婴互动有有害影响。因此，深入了解相关风险因素对于预防政策至关重要。本研究旨在估计2个月时PPA症状的患病率，并在2021年在法国分娩的所有妇女的代表性样本中，以及两个亚组中识别相关风险因素：无产后抑郁症（PPD）症状的妇女和无心理健康护理史的妇女。
方法
在2021年法国全国围产期代表性调查（ENP）纳入的12723名妇女中，7133名在产后2个月完成了爱丁堡产后抑郁量表（EPDS）自我管理问卷，其中包括三个特定于焦虑的项目（EPDS - 3A）。我们使用具有稳健方差的泊松回归模型估计PPA症状的调整患病率比（aPR）。
结果
2个月时PPA症状的患病率为27.6%（95%置信区间[26.5 - 28.8]）。相关风险因素包括：年龄≤34岁（25 - 29岁人群与35 - 39岁人群相比，最大aPR = 1.38 [1.22 - 1.58]）、健康素养较差（1.15 [1.07 - 1.23]）、有药物流产史（1.32 [1.05 - 1.68]）、自青春期以来有心理（1.31 [1.17 - 1.47]）或精神（1.42 [1.24 - 1.63]）护理史、未生育（1.23 [1.12 - 1.35]）、孕期体重未增加或减少（1.29 [1.03 - 1.61]与增加9 - 15千克相比）或增加≥23千克（1.20 [1.00 - 1.43]）、≥3次与妊娠相关的急诊会诊（1.16 [1.03 - 1.31]与无相比）、孕期获得的支持较差/良好（分别为1.16 [1.00 - 1.34]和1.15 [1.05 - 1.26]，与非常好相比）、孕期有悲伤情绪（1.52 [1.36 - 1.69]）、快感缺失（1.48 [1.27 - 1.72]）或两者皆有（1.99 [1.79 - 2.2
1]）、对分娩期间的疼痛管理完全不满意/不太满意（1.16 [1.01 - 1.32]与相当满意/非常满意相比）。在“无PPD症状”和“无心理健康护理史”亚组中发现了类似的风险因素。
结论
我们研究样本中2个月时PPA症状的估计患病率为27.6%。我们识别出的风险因素可能为未来的预防政策提供指导。
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