Maternal pain during pregnancy dose-dependently predicts postpartum depression: The Japan Environment and Children's Study
Maternal pain during pregnancy dose-dependently predicts postpartum depression: The Japan Environment and Children's Study
复制标题
怀孕期间母亲的疼痛剂量依赖性地预测产后抑郁症：日本环境与儿童研究
DOI：
10.1016/j.jad.2022.01.039
复制
发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Suganuma N
中科院分区：
文献类型：
--
作者：
Shigematsu-Locatelli M;Kawano T;Yasumitsu-Lovell K;Locatelli FM;Eitoku M;Suganuma N
背景：产后抑郁症（PPD）影响女性产后第一年。本研究调查了产前疼痛（怀孕期间母亲的疼痛）与 PPD 之间的关联。方法：数据分析来自日本环境与儿童研究 (JECS)，这是一项全国性前瞻性出生队列研究。怀孕期间通过自填问卷两次收集有关产前疼痛的信息。产后一个月使用爱丁堡产后抑郁量表评估 PPD 症状。采用泊松回归分析来调查产前疼痛与 PPD 之间的关联，并在模型中调整其他假定的危险因素。结果：在 84,801 名研究对象中，11,535 名 (13.6%) 被筛查为 PPD 阳性。在本研究中，妊娠早期和中/晚期产前疼痛的发生率分别为 69.6% 和 84.0%。在妊娠早期和中期/晚期观察到任何程度的疼痛与 PPD 之间存在正相关关系。当受试者除以疼痛严重程度时，还发现了显着的线性剂量依赖性关联（Ptrend < 0.001）。以在任一时间点没有任何疼痛的参与者作为参考，那些在妊娠早期和中期/晚期持续疼痛的参与者表现出最高的 PPD 风险：aRR=1.95（95%CI：1.76-2.15；p < 0.001）。局限性：JECS 问卷中没有关于产前疼痛类型或部位的详细信息，也没有关于分娩和产后疼痛的数据。结论：研究结果表明，产前疼痛是发生 PPD 的剂量依赖性危险因素。
Background: Postpartum depression (PPD) affects women during the first year after delivery. This study investigated the association between prenatal pain (maternal pain during pregnancy) and PPD.Methods: Data were analyzed from the Japan Environment and Children's Study (JECS), a nationwide prospective birth cohort study. Information on prenatal pain was collected twice during pregnancy through self-administered questionnaires. PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale at one month postpartum. Poisson regression analyses were performed to investigate the association between prenatal pain and PPD, with other putative risk factors adjusted in the model.Results: Among 84,801 study subjects, 11,535 (13.6%) were screened as positive for PPD. In the present study, the occurrence of prenatal pain was 69.6% and 84.0% at the first trimester and the second/third trimester, respectively. A positive relationship between any degree of pain and PPD in both the first and the second/third trimester was observed. A significant linear dose-dependent association was also found (Ptrend < 0.001) when the subjects were divided by the severity of pain. Using participants without any pain at either point as a reference, those with persistent pain both at the first and the second/third trimesters showed the highest risk for PPD: aRR = 1.95 (95%CI: 1.76-2.15; p < 0.001).Limitations: No detailed information regarding the type or site of prenatal pain was available in the JECS questionnaires, neither did data concerning delivery and postpartum pain.Conclusions: The study results suggest that prenatal pain is a dose-dependent risk factor for the development of PPD.