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妊娠并发症及其与产后抑郁症状的关联:一项回顾性研究。

Pregnancy complications and their association with postpartum depression symptoms: a retrospective study.

作者信息

Swart Taliah, Shandley Kerrie, Huynh Minh, Brown Christine M, Austin David W, Bhowmik Jahar

机构信息

School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.

School of Psychology, Deakin University, Geelong, VIC, Australia.

出版信息

Aust J Psychol. 2023 Aug 21;75(1):2247088. doi: 10.1080/00049530.2023.2247088. eCollection 2023.

Abstract

OBJECTIVE

Postpartum depression affects around 17% of the women worldwide and has considerable implications for maternal and child health. While some risk factors have been identified, the association between pregnancy and delivery complications and postpartum depression is less well understood. This study aims to determine whether specific pregnancy complications are associated with risk of postpartum depression symptoms (PPDS).

METHOD

This study analysed a subset of variables collected as part of a larger study exploring pregnancy circumstances and maternal-foetal health outcomes. Mothers residing in Australia provided information on their biological children aged 3-13 years. Pregnancy complications were analysed using bivariate analyses and binary logistic regression.

RESULTS

Mothers ( = 1,926) reported on  = 3,210 pregnancies (mean number of pregnancies = 1.27, SD = 0.97). At the time of childbirth, mothers were on average 30.1 years old (SD = 5.14). Experiencing a pregnancy complication increased the risk of PPDS (X = 16.45, df = 1,  < 0.001) However, logistic regression analyses indicated an increased risk of PPDS was associated with the specific pregnancy complications of cytomegalovirus (AOR = 7.06, 95% CI[1.51,32.98]), emergency caesarean (AOR = 1.67, 95% CI[1.31,2.12]), foetal distress before birth (AOR = 1.49, 95% CI[1.16,1.91]), induced labour (AOR = 1.55, 95% CI[1.25,1.91]) and placenta previa (AOR = 2.60, 95% CI[1.44,4.71]).

CONCLUSION

Specific pregnancy complications were associated with PPDS, suggesting that some complications may pose a greater risk for PPDS than others. This study contributes to the growing understanding of peripartum risk factors for postpartum depression, and suggests that early clinical identification of at-risk mothers and early prophylactic and supportive care may be warranted to reduce that risk.

摘要

目的

产后抑郁症影响着全球约17%的女性,对母婴健康有着重大影响。虽然已经确定了一些风险因素,但妊娠和分娩并发症与产后抑郁症之间的关联尚不太清楚。本研究旨在确定特定的妊娠并发症是否与产后抑郁症状(PPDS)的风险相关。

方法

本研究分析了作为一项探索妊娠情况和母婴健康结局的更大规模研究的一部分所收集的变量子集。居住在澳大利亚的母亲提供了有关其3至13岁亲生孩子的信息。使用双变量分析和二元逻辑回归分析妊娠并发症。

结果

母亲(n = 1926)报告了n = 3210次妊娠(平均妊娠次数 = 1.27,标准差 = 0.97)。分娩时,母亲的平均年龄为30.1岁(标准差 = 5.14)。经历妊娠并发症会增加患PPDS的风险(χ² = 16.45,自由度 = 1,p < 0.001)。然而,逻辑回归分析表明,患PPDS风险增加与以下特定妊娠并发症相关:巨细胞病毒感染(比值比[AOR] = 7.06,95%置信区间[CI][1.51, 32.98])、急诊剖宫产(AOR = 1.67,95% CI[1.31, 2.12])、产前胎儿窘迫(AOR = 1.49,95% CI[1.16, 1.91])、引产(AOR = 1.55,95% CI[1.25, 1.91])和前置胎盘(AOR = 2.60,95% CI[1.44, 4.71])。

结论

特定的妊娠并发症与PPDS相关,这表明某些并发症可能比其他并发症对PPDS构成更大风险。本研究有助于增进对产后抑郁症围产期风险因素的理解,并表明早期临床识别高危母亲以及早期预防性和支持性护理可能有助于降低该风险。

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本文引用的文献

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Risk Factors for Postpartum Depression: An Umbrella Review.产后抑郁症的危险因素:伞式综述。
J Midwifery Womens Health. 2020 Jan;65(1):96-108. doi: 10.1111/jmwh.13067. Epub 2020 Jan 22.

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