Prenatal predictors of postpartum depression trajectories from birth to 24 months amongst smoking women.
Prenatal predictors of postpartum depression trajectories from birth to 24 months amongst smoking women.
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吸烟女性从出生到 24 个月的产后抑郁症轨迹的产前预测因素。
DOI：
10.1111/jocn.16019
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发表时间：
2022-06
影响因子：
4.2
通讯作者：
Wen X
中科院分区：
文献类型：
--
作者：
Frndak S;Syed S;Saleh J;Kocher M;Wen X
我们的目的是确定产后抑郁症（PPD）的轨迹，并检查吸烟妇女的相关预测因素。PPD会对家庭产生不利影响。吸烟女性PPD轨迹的预测因素尚未得到充分研究。纵向队列研究。一组49名美国妇女（目前或以前吸烟）从出生到产后24个月完成了爱丁堡产后抑郁量表。使用潜在类别增长模型来识别PPD轨迹。确定PPD轨迹的预测因子，调整混杂因素。还评估了产前患者健康问卷（PHQ）抑郁评分的影响。在报告结果时遵循了STROBE指南。确定了三种PPD轨迹：非PPD、一过性PPD和慢性PPD。在多项logistic回归中，与非PPD轨迹相比，社会支持与慢性PPD轨迹中成员资格的几率较低相关：已婚或有伴侣分享资源（比值比OR=0.14 [0.02，0.85]，p值=0.03），更大的合作伙伴支持（OR=0.87 [0.77，0.98]，p值=0.02）和更大的家庭/朋友支持（OR=0.53 [0.34，0.82]，p值=0.004）。暂时性PPD与非PPD在任何预测因素上均无差异。在有序逻辑回归模型中，当产前PHQ抑郁评分在低范围内时，社会支持与更严重的PPD抑郁轨迹成员的可能性较低相关（已婚或有共享资源的伴侣：效应修正p =0.06;伴侣支持：效应修正p =0.05;家人/朋友支持：效应修正p =0.005）。与一般人群相比，慢性PPD轨迹在吸烟女性中更常见。社会支持是更严重的产后抑郁症轨迹的重要预测因子，特别是当产前抑郁症低。我们的研究结果表明，社会支持可能会降低严重的PPD轨迹的可能性，特别是当产前抑郁症是低的。暂时性PPD的相关预测因素仍然难以捉摸。
We aimed to identify postpartum depression (PPD) trajectories and examine relevant predictors among smoking women. PPD can adversely affect families. Predictors of PPD trajectories among smoking women are understudied. Longitudinal cohort study. A cohort of 49 U.S. women (current or ex-smoking) completed the Edinburgh Postnatal Depression Scale from birth to 24 months postpartum. Latent class growth modeling was used to identify PPD trajectories. Predictors of PPD trajectories were identified, adjusting for confounders. Effect modification by prenatal Patient Health Questionnaire (PHQ) depression score was also assessed. STROBE guidelines were followed in reporting results. Three PPD trajectories were identified: non-PPD, transient PPD, and chronic PPD. In multinomial logistic regression, social support was associated with lower odds of membership in the chronic PPD trajectory compared to non-PPD trajectory: being married or having a partner sharing resources (odds ratio OR=0.14 [0.02, 0.85], p-value=0.03), greater partner support (OR=0.87 [0.77, 0.98], p-value=0.02), and greater family/friends support (OR=0.53 [0.34, 0.82], p-value=0.004). Transient PPD showed no differences with non-PPD on any predictors. In ordinal logistic regression models, social support was associated with lower odds of membership in a more severe PPD depression trajectory when prenatal PHQ depression score was in the low range (being married or having a partner sharing resources: p for effect modification=0.06; partner support: p for effect modification=0.05; family/friends support: p for effect modification=0.005). Compared to the general population, chronic PPD trajectories were more common among smoking women. Social support was an important predictor of more severe PPD trajectories, especially when prenatal depression is low. Our findings indicated that social support might decrease likelihood of severe PPD trajectories, especially when prenatal depression was low. Relevant predictors of transient PPD remained elusive.
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