围产期抑郁轨迹与睡眠质量的动态相关性分析  

Dynamic correlation analysis between perinatal depression trajectroy and sleep quality

作　　者：王晨[1] 李安宁 Wang Chen;Li Anning(Department of Perinatal Medicine,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院北京妇幼保健院围产医学部,100026 [2]首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心,精神疾病诊断与治疗北京市重点实验室

出　　处：《北京医学》2023年第11期967-971,共5页Beijing Medical Journal

基　　金：北京妇产医院北京妇幼保健院2019年管理专项(FCYYGL201902)。

摘　　要：目的了解孕中期至产后3个月围产期抑郁轨迹,探讨其与围产期睡眠质量的动态关系。方法选取2020年1月至2021年6月首都医科大学附属北京妇产医院行产前检查的孕妇1506例。孕妇在孕中期(15~18周)至产后3个月进行5次调查,调查内容包括一般资料、爱丁堡产后抑郁量表(Edinburgh postnatal depression scale,EPDS)筛查和匹兹堡睡眠量表(Pittsburgh sleep quality index,PSQI)。使用潜在生长曲线(latent growth curve,LGC)模型绘制围产期抑郁轨迹,并分析围产期抑郁与睡眠质量的动态关系。结果1416例孕妇年龄(31.5±3.9)岁,社会经济地位(socioeconomic status,SES)得分(8.2±1.0)分,家庭月收入20000(15000,32750)元,已婚者1411例(99.6%),吸烟者389例(27.5%),初产者1097例(77.5%)。从孕15周起至产后3个月,围产期抑郁轨迹呈进行性上升趋势。睡眠质量轨迹的截距正向影响抑郁轨迹的截距(β=0.71,P<0.001),睡眠质量轨迹的斜率正向影响抑郁轨迹的二次项系数(β=0.24,P<0.01)。结论从孕15周起至产后3个月,围产期抑郁症状呈进行性加重趋势。睡眠质量对抑郁症状的动态影响可能从妊娠开始时即存在。围产期女性睡眠质量恶化的速度越快,出现抑郁症状骤然加重的时间越早。积极关注围产期女性睡眠质量,对围产期抑郁的早期预防和诊断有重要的意义。Objective To understand the trajectory of perinatal depression from the second trimester to the third months after delivery,and to explore the dynamic relationship with perinatal sleep quality.Methods A total of 1506pregnant women who have prenatal examination in Beijing Obstetrics and Gynecology Hospital from January 2020 to June 2021 were selected,and were conducted five surveys from the second trimester(15-18 weeks)to three months after delivery,the survey included general information,the Edinburgh postnatal depression scale(EPDS)and Pittsburgh sleep quality index(PSQI).The latent growth curve(LGC)model was used to plot perinatal depression trajectories and analyze the dynamic relationship between perinatal depression and sleep quality.Results The age of the 1416 pregnant women was(31.5±3.9)years,the socioeconomic status(SES)score was(8.2±1.0)score,the monthly household income was 20000(15000,32750)yuan;1411(99.6%)were married,and 389(27.5%)were smokers,there were 1097 primiparas(77.5%).From 15 weeks of pregnancy to three months postpartum,the trajectory of perinatal depression showed a progressive upward trend.The intercept of sleep quality trajectory positively affected the intercept of depression trajectory(β=0.71,P<0.001),and the slope of sleep quality trajectory positively affected the quadratic coefficient of depression trajectory(β=0.24,P<0.01).Conclusions From 15 weeks of pregnancy to three months postpartum,the perinatal depressive symptoms show a progressive worsening trend.The dynamic influence of sleep quality on depressive symptoms may exist from the beginning of pregnancy.The faster the sleep quality of perinatal women deteriorates,the earlier the depressive symptoms suddenly worsen.It is of great significance to pay attention to the sleep quality of perinatal women for the early prevention and diagnosis of perinatal depression.

关 键 词：围产期抑郁 睡眠质量 潜在生长曲线 

分 类 号：R749.4[医药卫生—神经病学与精神病学]