Reducing the Risk for Postpartum Depression in Adolescent Mothers: A Randomized Controlled Trial.
Reducing the Risk for Postpartum Depression in Adolescent Mothers: A Randomized Controlled Trial.
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降低青春期母亲产后抑郁的风险：一项随机对照试验。
DOI：
10.1097/aog.0000000000004003
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发表时间：
2020
影响因子：
7.2
通讯作者：
Zlotnick,Caron
中科院分区：
文献类型：
--
作者：
Phipps,MaureenG;Ware,CrystalF;Stout,RobertL;Raker,ChristinaA;Zlotnick,Caron
目的：评价以人际关系治疗为基础的干预对降低青春期产后抑郁风险的效果。方法：采用随机对照试验，纳入250名怀孕时年龄在18岁及以下的青少年。最初的样本量计算估计需要276名参与者(324名有自然减员)来检测主要结果-产后严重抑郁发作的风险降低50%，阿尔法为0.05%，威力为80%。数据安全和监测委员会的中期分析报告将样本规模目标修订为250个。参与者被随机分为干预组(n=129)或时间匹配的对照组(n=121)，他们参加了关于怀孕主题的会议。每组都接受了五次产前治疗和一次产后强化治疗。在基线和产后12个月的特定时间点进行结构化的诊断性访谈，以评估产后出现严重抑郁发作的情况。结果：参与者从2011年12月到2016年5月通过罗德岛州的城市产前保健地点招募。在250名参与者中，58%的人认为是西班牙裔，20%的人是黑人或非裔美国人。对照组产后12个月主要抑郁发生率为7.0%(95%CI 2.3~11.7%)，干预组为7.6%(95%CI 2.5~12.7%)，两组产后各时间点差异均无统计学意义(P=0.05)。结论：干预组和对照组在主要抑郁发作的发生率上无明显差异，这可能与对照组的严重抑郁发生率低于预期有关(实际为7.6%，预计为25%)。在研究期间为怀孕和为人父母的青少年提供更多的当地社区资源可能是对这一结果的解释。临床试验登记：临床试验。一项预防青少年产后抑郁症的计划在意想不到的低抑郁率和强有力的社区规划的背景下没有显示出任何好处。
OBJECTIVE:To estimate the effect of an interpersonal therapy-based intervention on reducing the risk of postpartum depression in adolescents.METHODS:A randomized controlled trial enrolled 250 pregnant adolescents who were aged 18 years or younger at conception. The initial sample size calculation estimated 276 participants (324 with attrition) were needed to detect a 50% reduction in risk of the primary outcome, postpartum major depressive episode, with an alpha of 0.05% and 80% power. An interim analysis by the Data Safety and Monitoring Committee informed a revision in the sample size target to 250. Participants were randomized to the intervention (n= 129) or a time-matched control group (n= 121) who attended sessions about pregnancy topics. Each group received five prenatal sessions and a postpartum booster session. A structured diagnostic interview was administered at baseline and specific time points through 12-months postpartum to assess for major depressive episode onset.RESULTS:Participants were recruited from December 2011 to May 2016 through urban prenatal care sites in the state of Rhode Island. Of the 250 participants, 58% identified as Hispanic and 20% as black or African American. The rate of major depressive episode by 12 months postpartum was 7.0%(95% CI 2.3–11.7%) in the control group and 7.6%(95% CI 2.5–12.7%) in the intervention group, with no significant difference between groups at any time point (P=. 88 by log-rank test).CONCLUSION:No benefit was shown between the intervention and control groups in the rates of major depressive episode, which is likely related to a lower than predicted rate of this outcome in the control group (7.6% actual vs 25% predicted). Enhanced local community resources available to pregnant and parenting adolescents during the study period may be an explanation for this result.CLINICAL TRIAL REGISTRATION:ClinicalTrials. gov, NCT01482832.A program to prevent adolescent postpartum depression showed no benefit in a setting of unexpected low rates of depression and strong community programming.
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预防青春期母亲产后抑郁症的随机对照试验。
影响因子：
9.8
作者：
Phipps,MaureenG;Raker,ChristinaA;Ware,CrystalF;Zlotnick,Caron
通讯作者：
Zlotnick,Caron
影响因子：
8
作者：
Earls, Marian F.;Yogman, Michael W.;Wissow, Lawrence
通讯作者：
Wissow, Lawrence
DOI：
10.1542/9781610020190-appendix01_sub27
发表时间：
2016-04
期刊：
Pediatric Clinical Practice Guidelines & Policies
影响因子：
--
作者：
通讯作者：
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孕产妇抑郁症：一个值得儿童保健从业者更多认识的老问题
影响因子：
3.6
作者：
Karen Zimmer;C. Minkovitz
通讯作者：
C. Minkovitz
影响因子：
6.6
作者：
Kessler, RC
通讯作者：
Kessler, RC