Clinical factors associated with a positive postpartum depression screen in people with cardiac disease during pregnancy.
Clinical factors associated with a positive postpartum depression screen in people with cardiac disease during pregnancy.
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DOI：
10.46439/psychiatry.2.027
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Bianco K
中科院分区：
文献类型：
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作者：
Panelli DM;Sherwin EB;Lee CJ;Leonard SA;Miller SE;Miller HE;Tolani AT;Hoover V;Ansari JR;Khandelwal A;Bianco K
虽然已知心脏病患者患抑郁症的终生风险增加，但对这一人群的产后抑郁症发病率知之甚少。描述产后抑郁症筛查阳性率并确定心脏病患者特有的风险因素可能有助于制定降低风险的策略。这项回顾性队列研究纳入了2014年至2020年期间在单一机构分娩的先天性和/或获得性心脏病妊娠患者。主要结局是产后抑郁筛查阳性，定义为爱丁堡产后抑郁评分（EPDS）≥10。先验地选择潜在的暴露，并使用Wilcoxon秩和Fisher精确检验比较有和没有阳性产后抑郁筛查的患者。次要结果是对发送给讲英语的患者的纵向随访调查的响应，评估心脏状态，心理健康和婴儿发育。在126名符合条件的心脏病患者中，23名（18.3%）产后抑郁筛查阳性。与筛查结果为阴性的患者相比，产后抑郁筛查结果为阳性的患者更有可能在产前接受肝素或依诺肝素抗凝治疗（56.5% vs 26.2%，p=0.007）、分娩期间输血（8.7% vs 0%，p=0.032）和产后母婴分离（52.2% vs 28.2%，p=0.047）。在29名对随访调查作出回应的阳性筛查患者中，50%的人报告被正式诊断为焦虑或抑郁，33.3%的人报告儿童发育问题。我们的研究结果强调了心脏病患者产后抑郁症筛查的重要性，特别是那些需要产前抗凝或产后母婴分离的患者。
While people with cardiac disease are known to be at increased lifetime risk of depression, little is known about postpartum depression rates in this population. Describing rates of positive postpartum depression screens and identifying risk factors that are unique to cardiac patients may help inform risk reduction strategies. This retrospective cohort study included pregnant patients with congenital and/or acquired cardiac disease who delivered at a single institution between 2014 and 2020. The primary outcome was a positive postpartum depression screen, defined as Edinburgh Postpartum Depression Score (EPDS) ≥10. Potential exposures were selected a priori and compared between patients with and without a positive postpartum depression screen using Wilcoxon rank-sum and Fisher’s exact tests. Secondary outcomes were responses to a longitudinal follow-up survey sent to English-speaking patients evaluating cardiac status, mental health, and infant development. Of 126 eligible cardiac patients, 23 (18.3%) had a positive postpartum depression screen. Patients with a positive postpartum depression screen were more likely to have had antepartum anticoagulation with heparin or enoxaparin (56.5% versus 26.2%, p=0.007), blood transfusion during delivery (8.7% versus 0%, p=0.032), and maternal-infant separation postpartum (52.2% versus 28.2%, p=0.047) compared to patients with a negative screen. Among 29 patients with a positive screen who responded to the follow up survey, 50% reported being formally diagnosed with anxiety or depression and 33.3% reported child development problems. Our results highlight the importance of screening for postpartum depression in patients with cardiac disease, especially those requiring antepartum anticoagulation or maternal-infant separation postpartum.