Advancing research on perinatal depression trajectories: Evidence from a longitudinal study of low-income women
Advancing research on perinatal depression trajectories: Evidence from a longitudinal study of low-income women
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DOI：
10.1016/j.jad.2022.01.026
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发表时间：
2022-01-12
影响因子：
6.6
通讯作者：
Goyal, D.
中科院分区：
文献类型：
--
作者：
Choi, C.;Mersky, J. P.;Goyal, D.
目的：本研究旨在描述和预测低收入妇女从怀孕前三个月到产后六个月的围产期抑郁轨迹。方法：研究样本包括899名接受家访服务的威斯康星州妇女。符合条件的参与者由家访人员使用爱丁堡产后抑郁量表在怀孕前三个月到产后六个月的四个时间段内至少三次筛查抑郁症状。应用生长混合模型识别不同的轨迹类别，并使用多项式Logistic回归分析类别成员的预测因素。结果：在这个种族/民族多样化的低收入女性样本中，抑郁症状的平均得分随着时间的推移显著下降，从时间1的8.1分下降到时间4的6.8分的低点。确定了四种类型，包括低稳定组(占样本的78.2%)、高稳定组(10.6%)以及减少(7.1%)和增加(4.1%)轨迹。有虐待史和精神健康困难的女性更有可能被归入高稳定组和下降抑郁组，而不是低稳定组。社会支持不足与产后抑郁的上升轨迹有关，产后抑郁水平较高。结论和启示：尽管大多数女性表现出稳定和积极的轨迹，但超过五分之一的女性表现出持续或间歇性的高抑郁评分。综上所述，这些发现强调了在整个围产期进行抑郁症筛查和确定可能被用于针对高危人群的资源的因素的重要性。
Objectives: The current study aimed to describe and predict perinatal depression trajectories in a sample of lowincome women from the first trimester of pregnancy to six months postpartum. Methods: The study sample consisted of 899 women in Wisconsin who received home visiting services. Eligible participants were screened for depressive symptoms by home visitors using the Edinburgh Postnatal Depression Scale at least three times across four time periods from the first trimester of pregnancy to six months postpartum. Growth Mixture Modeling was applied to identify distinct trajectory classes, and multinomial logistic regressions were performed to analyze predictors of class membership. Results: Mean depressive symptom scores in this racially/ethnically diverse sample of low-income women decreased significantly over time from a high of 8.1 at time1 to a low of 6.8 at time4. Four classes were identified, including a low-stable group (78.2% of sample), a high-stable group (10.6%) along with decreasing (7.1%) and increasing (4.1%) trajectories. Women with a history of abuse and mental health difficulties were more likely to be classified in the high-stable and decreasing depression groups than the low-stable group. Low social support was linked to an increasing trajectory that resulted in high levels of postpartum depression. Conclusions and implications: Although most women exhibited stable and positive trajectories, more than one out of five presented with either persistently or intermittently high depression scores. Taken together, the findings underscore the importance of depression screening throughout the perinatal period and identifying factors that may be used to target resources to at-risk populations.