不同年龄组女性围产期抑郁发生风险及影响因素分析  

Risk of and risk factors for perinatal depression among women in different age groups

作　　者：杜兴梅 邓淦元 杨中婷 邓春燕 闻萱 张亚访 陈莹 邓睿 黄源 DU Xingmei;DENG Ganyuan;YANG Zhongting;DENG Chunyan;WEN Xuan;ZHANG Yafang;CHEN Ying;DENG Rui;HUANG Yuan(School of Public Health,Kunming Medical University,Kunming,Yunnan 650500,China)

机构地区：[1]昆明医科大学公共卫生学院,云南昆明650500

出　　处：《中国预防医学杂志》2024年第3期300-306,共7页Chinese Preventive Medicine

基　　金：国家自然科学基金资助项目(72264020);中华医学基金会(CMB#19-338)。

摘　　要：目的 探讨不同年龄段女性围产期抑郁的发生风险及其影响因素,为孕产妇抑郁障碍的精准防治提供基础数据。方法 于2022年5月在云南省某少数民族聚居农业县对处于妊娠期和产后1年内的女性进行抑郁症状筛查。测量围产期抑郁的发生风险,并构建logistic回归模型探讨不同年龄段(0~<20岁、20~<35岁和≥35岁)女性发生围产期抑郁的影响因素。结果 共完成1 188名女性的围产期抑郁症状筛查和程度评估,症状检出率为12.96%,中重度症状检出率为4.97%。其中,低龄组孕产妇抑郁症状检出率(23.76%)高于适龄组(12.67%)和高龄组(5.56%)。低龄组孕产妇中重度抑郁症检出率(9.90%)高于适龄组(4.70%)和高龄组(2.78%)。焦虑症状是三组孕产妇发生围产期抑郁的共同危险因素。过去1年内经历过负性事件是低龄(OR=10.63, 95%CI:1.76~64.09)和高龄(OR=24.73, 95%CI:1.22~500.79)组发生围产期抑郁的危险因素。对于低龄组,居住在城市(OR=9.44,95%CI:1.61~55.41)更易发生围产期抑郁;对于适龄组,既往焦虑障碍史(OR=55.49,95%CI:3.28~937.87)、睡眠0~<7 h (OR=2.17,95%CI:1.21~3.90)和多梦(OR=2.86,95%CI:1.59~5.11)与围产期抑郁的发生有关。家庭支持是低龄(OR=0.36,95%CI:0.17~0.76)和适龄(OR=0.64,95%CI:0.52~0.77)组孕产妇发生围产期抑郁的保护因素。结论 低龄孕产妇的抑郁发生风险较高、程度较重;负性事件对低龄和高龄孕产妇发生抑郁的影响较大,获得家庭支持有助于减少低龄和适龄孕产妇发生抑郁的可能,缓解孕产妇焦虑情绪和解决睡眠问题对预防围产期抑郁症有重要意义。Objective To explore the risk of and risk factors for perinatal depression among women at different ages,so as to provide data for the precision prevention and treatment of maternal depression during and after preg⁃nancy.Methods In May 2022,pregnant and one-year postpartum women in a rural county of Yunnan Province with a large ethnic minority population were recruited for depressive symptoms screening to estimate the risk of perinatal depression.The women were divided into three age groups(0-<20 years,20-<35 years,and≥35 years),and the risk factors of perinatal depression in the different age groups were explored using logistic regres⁃sion models.Results A total of 1188 women were screened and evaluated for perinatal depressive symptoms.The detection rate of depressive symptoms was 12.96%,with that for severe depressive symptoms was 4.97%.Women in the 0-<20 years age group had higher detection rates of depressive symptoms(23.76%)and severe depressive symptoms(9.90%),compared with those in the 20-<35 years age group(12.67%and 4.70%)and those in the≥35 years age group(5.56%and 2.78%).Anxiety was a common risk factor for perinatal depression in all the three age groups.The experience of negative events in the past year was a risk factor for perinatal depression in women 0-<20 years(OR=10.63,95%CI:1.76-64.09)and women≥35 years(OR=24.73,95%CI:1.22-500.79).For women aged 0-<20,living in urban areas(OR=9.44,95%CI:1.61-55.41)was associated with higher odds of having perinatal depression;for women aged 20-<35 years,previous history of anxiety disorder(OR=55.49,95%CI:3.28-937.87),less than 7 h of sleep(OR=2.17,95%CI:1.21-3.90)and dream sleep(OR=2.86,95%CI:1.59-5.11)were associated with higher odds of developing perinatal de⁃pression.Family support was a protective factor for perinatal depression in women aged 0-<20(OR=0.36,95%CI:0.17-0.76)and women aged 20-<35 years(OR=0.64,95%CI:0.52-0.77).Conclusions Women aged 0-<20 have a higher risk of depression and more severe depression.Negative events have a great imp

关 键 词：围产期抑郁 危险因素 抑郁症状 发生率 

分 类 号：R749.41[医药卫生—神经病学与精神病学] R714[医药卫生—临床医学]