孕早期妇女抑郁焦虑共患与童年期不良经历的关联

目的 了解安徽省妇女孕早期焦虑抑郁共患(CAD)现状,探讨童年期不良经历(ACEs)对孕早期CAD的影响。方法 在孕早期孕妇中采用问卷方式收集孕妇基本信息和ACEs,并用爱丁堡产后抑郁量表(EPDS)和广泛性焦虑量表(GAD-7)评估孕妇抑郁及焦虑状况。采用χ²检验和多因素logistic回归分析ACEs类型和ACEs累积评分与CAD的关系。结果 3 521名孕妇纳入分析,CAD与ACEs检出率分别为14.3%和18.7%。家庭功能障碍、忽视、虐待的检出率分别为10.5%、9.1%、5.8%,均是CAD的危险因素(P<0.001)。随着ACEs累积分数的增加,CAD的发生风险也在增加(1分:OR=2.76,95%CI:2.11～3.62; 2分:OR=4.57,95%CI:2.88～7.25; ≥3分:OR=7.31,95%CI:4.56～11.70; 均P<0.001)。结论 ACEs与孕早期CAD存在关联,且存在累积效应。

The association between adverse childhood experiences and comorbid anxiety and depression in early pregnancy

Objective To describe the prevalence of early pregnancy comorbid anxiety and depression symptomology(CAD)in Anhui Province, and to investigate the relationship between adverse childhood experiences(ACEs)with CAD. Methods Women at early pregnancy were recruited, and the demographic characteristics and ACEs were collected by using questionnaires. Depression and anxiety symptoms were assessed by the Edinburgh Postnatal Depression Scale(EPDS)and 7-items Generalized Anxiety Disorder Scale(GAD-7). The chi-square test and multivariate logistic regression were used to analyze ACEs types and to explore the relationship between ACEs with CAD. Results 3 521 pregnancy women were included in the analysis. Early pregnancy detection rates of depression-anxiety comorbidity were 14.3%. About 18.7% of the respondents had experienced ACEs, and the detection rates of household dysfunction, neglect and abuse were 10.5%, 9.1% and 5.8%, respectively, all of which increased the risks of CAD(P<0.001). With the ACEs cumulative score increasing, the risks of CAD also increased(P for trend<0.001). Conclusion ACEs are associated with an increased risk of early pregnancy CAD, and there is a cumulative effect of ACEs on CAD.