Vozzola Amanda, Vozzola David E, Roussos-Ross Dikea
Texas A&M College of Medicine at Scott and White Temple, Department of Obstetrics and Gynecology, University of Florida College of Medicine, Temple, Texas, USA.
Medical Research Institute for Advanced Study, Coral Springs, Florida, USA.
Breastfeed Med. 2025 Jun 2. doi: 10.1089/bfm.2024.0109.
Before the COVID-19 pandemic, research studies indicated that breastfeeding was protective against postpartum depression (PPD). This study aimed to evaluate the impact of the COVID-19 pandemic on the protective association between breastfeeding and PPD. We performed a retrospective cohort study by comparing the Edinburgh Postnatal Depression Scale (EPDS) scores for patients in two cohorts, pre-COVID-19 (April 2019 to February 2020) and COVID-19 (April 2020 to February 2021). A cross-sectional design using descriptive statistics, Pearson correlations, analysis of variance (ANOVA), and stepwise multiple regression analysis (MRA) analyzed the EPDS scores of a prepandemic cohort ( = 448) and a pandemic cohort ( = 468) of women seen at a tertiary academic medical center for their first postpartum visit. In the prepandemic cohort, 77.3% of breastfeeding women exhibited an unlikely risk for PPD compared with 78.5% in the pandemic cohort. Pearson correlations showed that the breastfeeding group in both cohorts had significantly lower EPDS scores, was less likely to exhibit PPD, and had a lower risk of severe PPD. ANOVA showed that nonbreastfeeding women had significantly higher EPDS scores in both cohorts. Stepwise MRA showed that the EPDS item Q8 ("I have felt sad or miserable") was the most significant predictor of PPD in breastfeeding women (both cohorts) and nonbreastfeeding women (prepandemic cohort) but had escalated to Q9 ("I have been so unhappy that I have been crying") for nonbreastfeeding women in the pandemic cohort. In both the prepandemic and pandemic cohorts, breastfeeding women had significantly lower EPDS scores.
在新冠疫情之前，研究表明母乳喂养可预防产后抑郁症（PPD）。本研究旨在评估新冠疫情对母乳喂养与产后抑郁症之间保护关联的影响。我们通过比较两个队列（新冠疫情前，即2019年4月至2020年2月；以及新冠疫情期间，即2020年4月至2021年2月）患者的爱丁堡产后抑郁量表（EPDS）得分，进行了一项回顾性队列研究。采用描述性统计、皮尔逊相关性分析、方差分析（ANOVA）和逐步多元回归分析（MRA）的横断面设计，分析了在一家三级学术医疗中心进行首次产后访视的疫情前队列（n = 448）和疫情期间队列（n = 468）女性的EPDS得分。在疫情前队列中，77.3%的母乳喂养女性患产后抑郁症的风险较低，而在疫情期间队列中这一比例为78.5%。皮尔逊相关性分析表明，两个队列中的母乳喂养组EPDS得分均显著较低，患产后抑郁症的可能性较小，且患严重产后抑郁症的风险较低。方差分析表明，两个队列中的非母乳喂养女性EPDS得分均显著较高。逐步多元回归分析表明，EPDS第8项（“我感到悲伤或痛苦”）是母乳喂养女性（两个队列）和非母乳喂养女性（疫情前队列）产后抑郁症最显著的预测指标，但在疫情期间队列的非母乳喂养女性中，该指标已升级为第9项（“我非常不开心以至于一直在哭泣”）。在疫情前和疫情期间队列中，母乳喂养女性的EPDS得分均显著较低。
