成都地区孕产妇孕晚期和产后抑郁随访研究  

Antenatal and postnatal depression in Chengdu,China: a longitudinal study

作　　者：赵志梅[1] 赵霏 杨雪 温莹 徐明珏[1] 綦小蓉[5] 杨春霞[2] 潘雄飞[3] ZHAO Zhi-mei;ZHAO Fei;YANG Xue;WEN Ying;XU Ming-jue;QI Xiao-rong;YANG Chun-xia;PAN Xiong-fei(Institute of Medical Biology,Chinese Academy of Medical Sciences,Peking Union Medical College,Kunming 650118,China;Department of Epidemiology and Biostatistics,West China School of Public Health,Sichuan University,Chengdu 610041,China;Department of Epidemiology and Biostatistics,School of Public Health,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Molecular Epidemiology,Shenzhen Center for Disease Control and Prevention,Shenzhen 518055,China;Department of Obstetrics and Gynecology,West China Second University Hospital/West China Women＇s and Children＇s Hospital,Chengdu 610041,China)

机构地区：[1]中国医学科学院北京协和医学院医学生物学研究所,云南昆明650118 [2]四川大学华西公共卫生学院流行病与卫生统计学系,四川成都610041 [3]华中科技大学同济医学院公共卫生学院流行病与卫生统计学系,湖北武汉430030 [4]深圳市疾病预防控制中心分子流行病学研究室,广东深圳518055 [5]四川大学华西第二医院(妇产儿童医院)妇产科,四川成都610041

出　　处：《中华疾病控制杂志》2018年第10期1051-1054,共4页Chinese Journal of Disease Control & Prevention

基　　金：四川省科技计划项目(2016HH0070)

摘　　要：目的随访成都地区孕产妇孕晚期和产后抑郁状态,比较不同时点抑郁率,分析孕晚期和产后抑郁的关系。方法选择2013年10月~2014年2月,在四川大学华西第二医院门诊部进行产前检查的孕晚期妇女作为研究对象,以爱丁堡产后抑郁量表(Edinburgh postnatal depression scale,EPDS)为主要研究工具,分别在孕晚期、产后8周和18周评估抑郁症状。以13分为筛查有无抑郁症状的临界值。用广义估计方程分析不同时点抑郁率和EPDS得分,用单因素Logistic回归分析孕晚期抑郁和产后抑郁的关系。结果共纳入2 057位孕晚期妇女,其中1 665例完成产后8周随访,1 440例完成产后18周随访。孕晚期、产后8周和18周抑郁率分别为13. 8%、2. 2%和1. 7%,抑郁率间差异有统计学意义(χ~2=181. 448,P <0. 001)。孕晚期抑郁与产后抑郁有关(OR=3. 88,95%CI:2. 17~6. 94,P <0. 001)。孕晚期得分(8. 35±3. 93)最高,产后8周(3. 05±3. 28)次之,产后18周(2. 21±3. 03)最低。孕晚期得分与产后8周、18周得分均呈正相关,相关系数分别为0. 358和0. 128。结论随访人群孕晚期抑郁率高于产后抑郁率,且孕晚期抑郁与产后抑郁相关,孕晚期抑郁应被给予更多关注。Objective To examine the prevalence of antenatal depression during the third trimester and postnatal depression and their correlation among pregnant women in Chengdu. Methods Women during the third trimester of pregnancy （28-42 weeks of pregnancy） were screened for symptoms of depression using the Edinburgh Postnatal Depression Scale （EPDS） at antenatal clinics of the West China Second Hospital between October 2013 and February 2014. Postnatal depression was assessed at 8 weeks and 18 weeks postpartum using EPDS by phone. Antenatal and postnatal depressive symptoms were defined as having an EPDS score generalized estimating equation （GEE） was used to analyze the prevalence of depression and EPDS scores at three time points, and univariable logistic regression was used to explore associations between antennal and postnatal depression. Results A total of 2 057 pregnant women participated in the study, of whom 1 665 completed the survey at 8 weeks postpartum and 1 440 women completed the survey at 18 weeks postpartum. The prevalence of depression was 13.8% , 2. 2% , and 1.7% during the third trimester, at 8 weeks and 18 weeks postpartum, respectively, with statistically significant differences in the prevalence at three different time points （X2 = 181. 448, P 〈 0. 001 ）. Antenatal depression was associated with postnatal depression （ OR = 3.88,95% CI： 2. 17 - 6.94 ,P 〈 0. 001 ）. The mean score was 8. 35 ± 3.93 during the third trimester, 3.05 ± 3.28 at 8 weeks postpartum, and 2. 21±3.03 at 18 weeks postpartum. Positive correlation was noted between scores during the third trimester and at 8 weeks postpartum （ r = 0. 358） and between those during the third trimester and at 18 weeks postpartum （r = 0. 128）. Conclusion Symptoms of depression are more common during late pregnancy than after childbirth, and are correlated with each other at the two phases. Attention should be directed to antenatal depression during the late pregnancy.

关 键 词：孕期抑郁 产后抑郁 随访研究 

分 类 号：R181.2[医药卫生—流行病学]