One-year trajectories of postpartum depressive symptoms and associated psychosocial factors: findings from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study
One-year trajectories of postpartum depressive symptoms and associated psychosocial factors: findings from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study
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DOI：
10.1016/j.jad.2021.08.118
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发表时间：
2021-09-09
影响因子：
6.6
通讯作者：
Tomita, Hiroaki
中科院分区：
文献类型：
--
作者：
Kikuchi, Saya;Murakami, Keiko;Tomita, Hiroaki
背景：产后抑郁症状在产后1年内的发展轨迹及其相关危险因素尚不清楚。因此，本研究旨在研究产后抑郁症状的1年轨迹及其相关的危险因素。研究方法：2013年7月至2016年9月，在日本东北医疗Megabank项目出生和三代队列研究中，共招募了22，493名孕妇。其中，11，668名无缺失数据的女性被纳入分析。产后1个月和1年的抑郁症状进行了评估，使用爱丁堡产后抑郁量表。校正协变量后进行多项logistic回归分析。结果：产后1个月抑郁症患病率为13.9%，产后1年抑郁症患病率为12.9%。我们确定了四种抑郁轨迹，即，“持续性（产后1年抑郁）”（6.0%）、“恢复性（产后1个月抑郁，1年内恢复）”（7.9%）、“晚发性（产后1个月后抑郁）”（6.8%）和“恢复性（产后1年不抑郁）”（79.2%）。妊娠期间的心理困扰与所有轨迹显著相关（持续性：比值比[OR]= 10.24，95%置信区间（CI）=8.40-12.48;恢复：OR=3.78，95%CI=3.28-4.36;晚发：OR=3.96，95%CI=3.40-4.62）。局限性：产后抑郁症仅通过自填问卷进行评估，脱落率不容忽视。结论：这项研究强调了产后1年抑郁症状的高患病率，并发现1年时一半的抑郁症状是迟发性的。研究结果表明，围产期心理健康的长期随访（长达1年）的必要性。
Background: Trajectories of postpartum depressive symptoms up to 1 year after childbirth and the related risk factors remain unclear. Accordingly, this study aimed to examine the 1-year trajectories of postpartum depressive symptoms and their associated risk factors. Methods: A total of 22,493 pregnant women were recruited between July 2013 and September 2016 in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Among them, 11,668 women with no missing data were included in the analyses. Depressive symptoms were assessed at 1 month and 1 year postpartum using the Edinburgh Postnatal Depression Scale. Multinominal logistic regression analysis was conducted after adjusting for covariates. Results: The prevalence of depression was 13.9% at 1 month and 12.9% at 1 year postpartum. We identified four depression trajectories, i.e., "persistent (depressed throughout the 1 year postpartum)" (6.0%), "recovered (depressed at 1 month postpartum and recovered within a year)" (7.9%), "late-onset (became depressed after 1 month postpartum)" (6.8%), and "resilient (not depressed throughout 1 year postpartum)" (79.2%). Psychological distress during pregnancy was significantly associated with all trajectories (persistent: odds ratio [OR]= 10.24, 95% confidence interval (CI)=8.40-12.48; recovered: OR=3.78, 95%CI=3.28-4.36; and late-onset: OR=3.96, 95%CI=3.40-4.62). Limitations: Postpartum depression was evaluated only by a self-administered questionnaire and the dropout rate was not neglectable. Conclusions: This study highlighted the high prevalence of depressive symptoms at 1 year postpartum and found that half of the depressive symptoms at 1 year were late-onset. The findings suggest the necessity of long-term follow-up (up to 1 year) for perinatal mental health.