The Association of Stillbirth with Depressive Symptoms 6-36 Months Post-Delivery
The Association of Stillbirth with Depressive Symptoms 6-36 Months Post-Delivery
复制标题
DOI：
10.1111/ppe.12176
复制
发表时间：
2015-03-01
影响因子：
2.8
通讯作者：
Goldenberg, Robert L.
中科院分区：
文献类型：
--
作者：
Hogue, Carol J. R.;Parker, Corette B.;Goldenberg, Robert L.
背景：死产（>= 20周妊娠），约占美国怀孕的200分之一，可能会让父母深感悲痛。未解决的悲伤可能会导致持续的抑郁症。我们比较了2009年的抑郁症状在2006-08年进行的死产协作研究网络的基于人群的病例对照研究中，在同意的妇女中（死产者n=275，健康活产者n=522，在爱丁堡抑郁量表上，除活产外，12例被归类为目前抑郁。根据单变量和多变量logistic模型计算粗（cOR）和校正（aOR）比值比和95%置信区间[CI]，并对研究设计和不同同意进行加权。边缘结构模型检查潜在的选择偏差，由于低follow-up.Results：目前抑郁症更可能在妇女死产（14.8%）与健康的活产（8.3%，cOR 1.90 [95%CI 1.20，3.02]）。然而，在控制了抑郁症史和与抑郁症和死产相关的因素后，死产相关性不再显著（aOR 1.35 [95%CI 0.79，2.30]）。相反，对于76%的妇女没有抑郁症的历史，一个显着的关联仍然调整后的混杂因素（aOR 1.98 [95%CI 1.02，3.82]）。结论：改善抑郁症的筛查和转诊可能需要妇女的健康护理。研究应侧重于确定支持死产妇女的最佳方法，以降低随后患抑郁症的风险。
Background: Stillbirths (>= 20 weeks' gestation), which account for about 1 in 200 US pregnancies, may grieve parents deeply. Unresolved grief may lead to persistent depression.Methods: We compared depressive symptoms in 2009 (6-36 months after index delivery) among consenting women in the Stillbirth Collaborative Research Network's population-based case-control study conducted 2006-08 (n=275 who delivered a stillbirth and n=522 who delivered a healthy livebirth (excluding livebirths12 on the Edinburgh Depression Scale were classified as currently depressed. Crude (cOR) and adjusted (aOR) odds ratios and 95% confidence intervals [CI] were computed from univariate and multivariable logistic models, with weighting for study design and differential consent. Marginal structural models examined potential selection bias due to low follow-up.Results: Current depression was more likely in women with stillbirth (14.8%) vs. healthy livebirth (8.3%, cOR 1.90 [95% CI 1.20, 3.02]). However, after control for history of depression and factors associated with both depression and stillbirth, the stillbirth association was no longer significant (aOR 1.35 [95% CI 0.79, 2.30]). Conversely, for the 76% of women with no history of depression, a significant association remained after adjustment for confounders (aOR 1.98 [95% CI 1.02, 3.82]).Conclusions: Improved screening for depression and referral may be needed for women's health care. Research should focus on defining optimal methods for support of women suffering stillbirth so as to lower the risk of subsequent depression.