Latent trajectory groups of perinatal depressive and anxiety symptoms from pregnancy to early postpartum and their antenatal risk factors
Latent trajectory groups of perinatal depressive and anxiety symptoms from pregnancy to early postpartum and their antenatal risk factors
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DOI：
10.1007/s00737-018-0845-y
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发表时间：
2018-12-01
影响因子：
4.5
通讯作者：
Muhajarine, Nazeem
中科院分区：
文献类型：
--
作者：
Ahmed, Asma;Feng, Cindy;Muhajarine, Nazeem
本研究的目的是确定从怀孕到产后早期表现出不同的抑郁和焦虑障碍轨迹模式的女性亚组，以及与潜在轨迹组成员资格相关的危险因素。 2006 年至 2007 年期间，对来自怀孕和母亲感受 (FIP) 纵向研究的女性 (n=615) 从怀孕早期到产后早期进行了为期 7 个月的跟踪调查。使用基于半参数组的轨迹建模方法来识别潜在轨迹组。然后使用多项 Logit 模型来探索潜在轨迹组成员资格与产前特征之间的关联。我们确定了围产期抑郁症状的四个潜在轨迹组：“低稳定”（49.6％）、中稳定（42.3％）、“产后”（3.6％）和产前（4.6％）。与这些轨迹组成员资格相关的重要风险因素是过去的抑郁症、压力水平、种族、母亲的年龄和关系满意度。确定了围产期焦虑症状的三个潜在轨迹组：“非常低稳定”（8.9%）； “低稳定性”（60.7%）；和中等稳定（30.4%）。与这些轨迹相关的重要风险因素是过去的抑郁症、压力水平和收入水平。确定了围产期抑郁和焦虑症状的潜在轨迹组，以揭示人群中潜在的异质性。我们的研究结果支持从怀孕早期到产后进行多重评估的必要性，这可以为高症状负担轨迹女性的特征提供一些重要的见解，以便进行早期干预，从而改变其精神症状的进展。
The aim of this study is to identify subgroups of women who exhibit distinct trajectory patterns of depressive and anxiety disorders from pregnancy to early postpartum and the risk factors associated with the latent trajectory group memberships. Women (n=615) from the Feelings in Pregnancy and Motherhood (FIP) longitudinal study were followed from early pregnancy to early postpartum for a 7-month period in 2006-2007. The semi-parametric group-based trajectory modeling approach was used to identify the latent trajectory groups. Multinomial logit models were then used to explore the association between latent trajectory group membership and antenatal characteristics. We identified four latent trajectory groups of perinatal depressive symptoms: "low-stable" (49.6%), moderate-stable (42.3%), "postpartum" (3.6%), and antepartum (4.6%). Significant risk factors associated with these trajectory group memberships were past depression, stress level, ethnicity, the mother's age, and relationship satisfaction. Three latent trajectory groups of perinatal anxiety symptoms were identified: "very low-stable" (8.9%); "low-stable" (60.7%); and moderate-stable (30.4%). Significant risk factor associated with these trajectories were past depression, stress level, and income level. Latent trajectory groups of perinatal depressive and anxiety symptoms were identified to uncover potential heterogeneity in populations. Our findings support the need for multiple assessments starting from early pregnancy to the postpartum, which can give some important insights on the characteristics of the women at high symptom burden trajectories for early interventions that may alter the progress of their mental symptoms.