Distinct Trajectories of Perinatal Depressive Symptomatology: Evidence From Growth Mixture Modeling
Distinct Trajectories of Perinatal Depressive Symptomatology: Evidence From Growth Mixture Modeling
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DOI：
10.1093/aje/kwn283
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发表时间：
2009-01-01
影响因子：
5
通讯作者：
Culhane, Jennifer F.
中科院分区：
文献类型：
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作者：
Mora, Pablo A.;Bennett, Ian M.;Culhane, Jennifer F.
虽然异质性的时间和持续性的孕产妇抑郁症的筛查和治疗以及相关的孕产妇和儿童的健康结果的影响，很少有人知道这种变化。一项前瞻性观察性研究，纳入了1,735名低收入、多种族、市中心的妇女，这些妇女在2000年至2002年期间怀孕，并前瞻性地随访至2004年（1次产前访谈和3次产后访谈），以确定是否可以从怀孕到产后2年定义抑郁症的不同轨迹。通过一般生长混合物建模进行分析。一个具有5个轨迹类的模型表征了来自宾夕法尼亚州费城的研究参与者中抑郁症状的时间和程度的异质性。这些类别包括以下内容：1）总是或慢性抑郁症状（7%）; 2）仅产前（6%）; 3）产后，产后第一年后消退（9%）; 4）晚期，产后25个月时出现（7%）;和5）从未有过抑郁症状（71%）。这些轨迹类中的妇女在人口统计学（出生，教育，种族，产次）健康，健康行为和心理社会特征（对怀孕和高客观压力的矛盾心理）方面存在差异。这种异质性应考虑在孕产妇抑郁症的程序。需要进行更多的研究，以确定这些轨迹类与孕产妇和儿童健康结果的关联。
Although heterogeneity in the timing and persistence of maternal depressive symptomatology has implications for screening and treatment as well as associated maternal and child health outcomes, little is known about this variability. A prospective observational study of 1,735 low-income, multiethnic, inner-city women recruited in pregnancy from 2000 to 2002 and followed prospectively until 2004 (1 prenatal and 3 postpartum interviews) was used to determine whether distinct trajectories of depressive symptomatology can be defined from pregnancy through 2 years postpartum. Analysis was carried out through general growth mixture modeling. A model with 5 trajectory classes characterized the heterogeneity seen in the timing and magnitude of depressive symptoms among the study participants from Philadelphia, Pennsylvania. These classes included the following: 1) always or chronic depressive symptomatology (7%); 2) antepartum only (6%); 3) postpartum, which resolves after the first year postpartum (9%); 4) late, present at 25 months postpartum (7%); and 5) never having depressive symptomatology (71%). Women in these trajectory classes differed in demographic (nativity, education, race, parity) health, health behavior, and psychosocial characteristics (ambivalence about pregnancy and high objective stress). This heterogeneity should be considered in maternal depression programs. Additional research is needed to determine the association of these trajectory classes with maternal and child health outcomes.