Antenatal depressive symptoms and maternal health care utilisation: a population-based study of pregnant women in Ethiopia.
Antenatal depressive symptoms and maternal health care utilisation: a population-based study of pregnant women in Ethiopia.
复制标题
DOI：
10.1186/s12884-016-1099-1
复制
发表时间：
2016-10-10
影响因子：
3.1
通讯作者：
Fekadu A
中科院分区：
文献类型：
--
作者：
Bitew T;Hanlon C;Kebede E;Medhin G;Fekadu A
怀孕期间的抑郁症状可能会对围产期结局产生多种不利影响，包括孕产妇发病率和死亡率。然而，低收入和中等收入国家 (LMIC) 很少探讨产前抑郁症状对孕产妇保健使用的潜在影响。本文调查了孕产妇保健利用是否随产前抑郁症状而变化。在一项基于人口的横断面调查中，埃塞俄比亚南部古拉格地区索多地区招募了 1311 名怀孕中期或晚期的妇女。使用当地验证版本的患者健康问卷 (PHQ-9) 来测量抑郁症状。使用泊松回归检查产前抑郁症状与产前保健 (ANC) 就诊次数之间的关联，并使用负二项回归检查抑郁症状与紧急医疗保健就诊次数之间的关联。二元逻辑回归用于调查抑郁症状与产前护理的开始、频率和充分性的关系。在 PHQ-9 截止到 5 个或更多时，29.5% 的参与者有抑郁症状。大多数 (60.5%) 女性曾参加过一次或多次 ANC 就诊。有抑郁症状的女性接受更多非定期 ANC 就诊的风险增加（调整后风险比 (aRR) = 1.41，95% CI：1.20, 1.65），并且传统医疗服务提供者（aRR = 1.64，95% CI：1.17, 2.31）和生物医学提供者的紧急医疗就诊次数增加（aRR = 1.31，95% CI：1.04，1.69） 用于与怀孕相关的紧急情况。然而，产前抑郁症状与 ANC 的启动没有显着相关性。非定期 ANC 和紧急医疗保健就诊次数的增加可能是产前妇女未被发现的抑郁症的指标，并且有可能超出医疗保健系统的能力和资源，特别是在中低收入国家。建立产前抑郁症的检测、转诊和治疗系统，并将其纳入现有的产前保健中，可以降低产前发病率和治疗成本，并提高卫生保健系统的效率。
Depressive symptoms during pregnancy can have multiple adverse effects on perinatal outcomes, including maternal morbidity and mortality. The potential impact of antenatal depressive symptoms on maternal health care use, however, has been little explored in low and middle-income countries (LMICs). This paper investigates whether maternal health care utilisation varies as a function of antenatal depressive symptoms. In a population-based cross-sectional survey, 1311 women in the second or third trimesters of pregnancy were recruited in Sodo district, Gurage Zone, southern Ethiopia. Depressive symptoms were measured using a locally validated version of the Patient Health Questionnaire (PHQ-9). The association between antenatal depressive symptoms and number of antenatal care (ANC) visits was examined using Poisson regression and the association of depression symptoms with emergency health care visits using negative binomial regression. Binary logistic regression was used to investigate the association of depressive symptoms with initiation, frequency and adequacy of antenatal care. At PHQ-9 cut off of five or more, 29.5 % of participants had depressive symptoms. The majority (60.5 %) of women had attended for one or more ANC visits. Women with depressive symptoms had an increased risk of having more non-scheduled ANC visits (adjusted Risk Ratio (aRR) = 1.41, 95 % CI: 1.20, 1.65), as well as an increased number of emergency health care visits to both traditional providers (aRR = 1.64, 95 % CI: 1.17, 2.31) and biomedical providers (aRR = 1.31, 95 % CI: 1.04, 1.69) for pregnancy-related emergencies. However, antenatal depressive symptoms were not significantly associated with initiation of ANC. Increased non-scheduled ANC and emergency health care visits may be indicators of undetected depression in antenatal women, and have the potential to overwhelm the capacity and resources of health care systems, particularly in LMICs. Establishment of a system for detection, referral and treatment of antenatal depression, integrated within existing antenatal care, may reduce antenatal morbidity and treatment costs and promote efficiency of the health care system.
登录
查看更多内容
影响因子：
5
作者：
Dayan, J;Creveuil, C;Thouin, A
通讯作者：
Thouin, A
影响因子：
3.7
作者：
Bradley, Elizabeth H.;Byam, Patrick;Curry, Leslie A.
通讯作者：
Curry, Leslie A.
影响因子：
1.2
作者：
Berhan Y;Berhan A
通讯作者：
Berhan A
影响因子：
--
作者：
DiMatteo, MR;Lepper, HS;Croghan, TW
通讯作者：
Croghan, TW
影响因子：
2.6
作者：
Alder, Judith;Fink, Nadine;Bitzer, Johannes
通讯作者：
Bitzer, Johannes