Patterns of Pregnancy and Postpartum Depressive Symptoms: Latent Class Trajectories and Predictors
Patterns of Pregnancy and Postpartum Depressive Symptoms: Latent Class Trajectories and Predictors
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DOI：
10.1037/abn0000246
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发表时间：
2017-02-01
影响因子：
4.6
通讯作者：
Moe, Vibeke
中科院分区：
文献类型：
--
作者：
Fredriksen, Eivor;von Soest, Tilmann;Moe, Vibeke
孕妇和产后妇女的抑郁症状很常见。然而，最近的研究表明，抑郁症状在围产期不遵循一个统一的过程，和调查的异质性的时间进程和相关因素是必要的。本研究的目的是探讨围产期的抑郁症状是否可以分为几个不同的轨迹之间的围产期妇女亚组的症状发展，并确定这些轨迹组的预测因子。这项研究使用了1,036名挪威妇女的数据，这些妇女参加了一项以社区为基础的前瞻性研究，从怀孕中期到产后12个月。在7个时间点（4个在怀孕期间）用爱丁堡产后抑郁量表评估抑郁症状。在入组时评估了伴侣相关依恋、压力、童年逆境、妊娠相关焦虑、既往精神病理学和社会经济状况。通过基于分段生长曲线的生长混合模型，确定了4类抑郁症状轨迹，包括（a）仅妊娠（4.4%）;（B）仅产后（2.2%）;（c）中度持续（10.5%）;和（d）最小症状（82.9%）类。多项Logistic回归分析表明，成员在怀孕和产后只有类主要是与妊娠相关的焦虑和以前的精神病理学，分别，而中度持久类与各种心理社会逆境因素。研究结果表明，异质性升高的抑郁情绪的时间模式，相关的特定轨迹的时间进程与不同的逆境因素。研究人员和临床医生应该意识到围产期抑郁情绪升高的可能多个过程，并询问可能的不同逆境因素，异常通路和疾病。
Depressive symptoms among pregnant and postpartum women are common. However, recent studies indicate that depressive symptoms in the perinatal period do not follow a uniform course, and investigations of the heterogeneity of time courses and associated factors are needed. The aim of this study was to explore whether depressive symptoms in the perinatal period could be categorized into several distinct trajectories of symptom development among subgroups of perinatal women, and to identify predictors of these trajectory groups. The study used data from 1,036 Norwegian women participating in a community-based prospective study from midpregnancy until 12-months postpartum. Depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale at 7 time points (4 during pregnancy). Partner-related attachment, stress, childhood adversities, pregnancy-related anxiety, previous psychopathology, and socioeconomic conditions were assessed at enrollment. By means of growth mixture modeling based on piecewise growth curves, 4 classes of depressive symptom trajectories were identified, including (a) pregnancy only (4.4%); (b) postpartum only (2.2%); (c) moderate-persistent (10.5%); and (d) minimum symptoms (82.9%) classes. Multinomial logistic regression analyses showed that membership in the pregnancy only and postpartum only classes primarily was associated with pregnancy-related anxiety and previous psychopathology, respectively, whereas the moderate-persistent class was associated with diverse psychosocial adversity factors. Findings suggest heterogeneity in temporal patterns of elevated depressive mood, relating specific trajectories of time courses with distinct adversity factors. Researchers and clinicians should be aware of possible multiple courses of elevated perinatal depressive mood, and inquire about possible diverse adversity factors, aberrant pathways, and prognoses.