孕育史对孕期抑郁影响的前瞻性队列研究

  目的   探究孕育史对妊娠各期抑郁发生的影响。   方法   使用中国孕产妇队列研究·协和项目中孕育史与妊娠各期抑郁数据完整的3 792名孕妇进行研究。采用爱丁堡产后抑郁量表测量孕妇的抑郁状况。采用χ2检验进行单因素分析, 采用Log-binomial回归模型进行多因素分析, 计算调整相对危险度(relative risk, RR)值及其95%可信区间(confidence interval, CI), 并用森林图进行展示。   结果   Log-binomial回归结果显示, 分娩史增加孕妇孕中期抑郁(RR:1.04, 95% CI:1.01~1.08, P=0.042)和孕晚期抑郁(RR:1.05, 95% CI:1.01~1.10, P=0.020)的发生风险; 与无剖宫产史的孕妇相比, 有剖宫产史的孕妇孕晚期抑郁风险增加了6%(RR:1.06, 95% CI:1.01~1.11, P=0.041)。   结论   孕育史对妊娠抑郁的发生有重要影响, 妇幼保健人员应重点关注此类孕妇, 并开展针对性的健康宣教和心理护理, 加强对孕妇情绪变化的观察并及时给予心理调整。

Influence of reproduction history on depression during pregnancy:a prospective cohort study

Objective To explore the influence of reproduction history on depression during pregnancy.Methods Data on 3792 pregnant women from the Chinese pregnant women cohort study with complete information on reproduction history and depression were used in the present study.The Edinburgh postnatal depression scale was used to assess depression status among pregnant women.A chi-square test was used for univariate analysis,and a Log-binomial regression was used for multivariate analysis.The adjusted relative risks(RRs)with 95%confidence intervals(95%CIs)were calculated,and were presented in a forest plot.Results The results of Log-binomial regression showed that a history of delivery could increase the risk of depression during the second trimester(RR:1.04,95%CI:1.01-1.08,P=0.042)and the third trimester(RR:1.05,95%CI:1.01-1.10,P=0.020).There was a 6%increase of risk on depression in women with a history of cesarean delivery compared with women without that during the third trimester(RR:1.06,95%CI:1.01-1.11,P=0.041).Conclusions There is a significant influence of reproduction history on gestational depression.Maternal and child health personnel should focus on these pregnant women,and conduct targeted health education and mental nursing.In addition,medical personnel should also pay attention to the emotional changes of these women and provide them with several adjustment strategies.