Psychosocial risk factors for postpartum depression and their relation to timing of onset: The Hamamatsu Birth Cohort (HBC) Study
Psychosocial risk factors for postpartum depression and their relation to timing of onset: The Hamamatsu Birth Cohort (HBC) Study
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DOI：
10.1016/j.jad.2011.07.012
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发表时间：
2011-12-01
影响因子：
6.6
通讯作者：
Takei, Nori
中科院分区：
文献类型：
--
作者：
Mori, Tsuruko;Tsuchiya, Kenji J.;Takei, Nori
背景资料：文献中定义的产后抑郁症（PPD）的时间范围在研究中有所不同-分娩后4周或3个月。为了解决潜在的差异，PPD发病的疾病，我们调查的危险因素为早发性和迟发性PPD使用一个有代表性的出生cohort in Japanes.Methods：我们评估了675名妇女谁完成了爱丁堡产后抑郁量表（EPDS）的两到三次分娩后3个月内。产后4周内发生PPD（EPDS ≥ 9分）的母亲被归类为早发性PPD，产后5 ~ 12周发生PPD的母亲被归类为晚发性PPD。我们采用多项逻辑回归调查与每一个早发型和晚发型PPD的危险因素，同时允许所有的危险因素先验选择的model.Results：早期和晚发型PPD的时期患病率分别为11%和4%，分别。初产仅与早发性PPD相关（OR = 2.6，95%CI 1.5-4.4）。参与研究的女性中，年龄较轻（≥ 35岁：OR = 2.5，95%CI 1.1-5.8）的女性仅与晚发型PPD显著相关。缺乏情感上的支持和抑郁/焦虑的历史似乎增加风险的早期和晚发性PPD.Limitations：适度的样本量和诊断PPD不使用结构化interviews可能会限制generalisability的findings.Conclusion：发现风险集为早期和晚发性PPD不同表明，这两种类型可能有不同的病因。(C)2011爱思唯尔有限公司版权所有。
Background: The time frame for postpartum depression (PPD) defined in the literature differs among studies - either 4 weeks or 3 months after childbirth. To address potential difference in PPD in relation to onset of the illness, we investigated risk factors for early- and late-onset PPD using a representative birth cohort in Japan.Methods: We evaluated 675 women who completed the Edinburgh Postnatal Depression Scale (EPDS) for two to three times within 3 months after childbirth. Mothers with an onset of PPD (>= 9 points on EPDS) within 4 weeks after childbirth were classified as having early-onset PPD, and those with PPD that occurred during the period of the 5th to 12th week after childbirth were classified as having late-onset PPD. We adopted multinomial logistic regression to investigate risk factors associated with each of early- and late-onset PPD, whilst simultaneously allowing for all risk factors a priori selected in the model.Results: The period prevalence of early- and late-onset PPD was 11% and 4%, respectively. Primiparity was associated only with early-onset PPD (OR = 2.6, 95%CI 1.5-4.4). Younger (= 35 years: OR = 2.5, 95%CI 1.1-5.8) of the participating women was significantly associated only with late-onset PPD. Lack of emotional support and a history of depression/anxiety appeared to increase risk both for early- and late-onset PPD.Limitations: Moderate sample size and diagnosis of PPD without use of structured interviews may limit generalisability of the findings.Conclusion: The finding that risk sets for early- and late-onset PPD differ suggests that these two types may have different aetiology. (C) 2011 Elsevier B.V. All rights reserved.