Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China
Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China
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DOI：
10.1016/j.ajog.2020.05.009
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发表时间：
2020-08-01
影响因子：
9.8
通讯作者：
Huang, He-feng
中科院分区：
文献类型：
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作者：
Wu, Yanting;Zhang, Chen;Huang, He-feng
背景：2020年1月20日，中国政府正式宣布了一场新的人际传播的冠状病毒疫情，这在中国引起了重大的公众恐慌。鉴于2019年冠状病毒病的爆发，孕妇可能特别脆弱，特别需要预防性心理健康战略。到目前为止，还没有关于孕妇对2019年冠状病毒病暴发的心理健康反应的调查报告。目的：本研究旨在研究2019年冠状病毒病暴发对中国孕妇抑郁和焦虑症状及其相关危险因素的影响。研究设计：2019年12月初启动了一项多中心横断面研究，使用爱丁堡产后抑郁量表确定怀孕期间的心理健康问题。这项研究为比较2019年冠状病毒疫情宣布前后孕妇的心理状态提供了一个独特的机会。这项横断面研究从2020年1月1日至2020年2月9日，对来自中国全国10个省的25家医院的4,124名妊娠晚期妇女进行了检查。在这些妇女中，有1285人在2020年1月20日冠状病毒疫情公开宣布之后进行了评估，2839人在这一关键时间点之前进行了评估。使用国际推荐的爱丁堡产后抑郁量表评估母亲的抑郁和焦虑症状。结果：2019年冠状病毒疫情报告后评估的孕妇抑郁症状发生率(26.0%)明显高于疫情报告前评估的孕妇抑郁症状发生率(29.6%，P=0.02)。这些女性也更有可能有自我伤害的想法(P=0.005)。抑郁率与2019年新确诊的冠状病毒病病例数量(P=.003)、疑似感染病例(P=.004)和每天的死亡人数(P=.001)呈正相关。孕前体重过轻、初产、35岁以下、全职工作、中等收入、有适当居住空间的孕妇在疾病暴发期间出现抑郁和焦虑症状的风险增加。结论：2019年冠状病毒病暴发等威胁生命的重大公共卫生事件可能增加孕妇患精神疾病的风险，包括有自我伤害的想法。针对母亲压力和孤立的战略，例如有效的风险沟通和提供心理急救，对于防止妇女及其胎儿的不良后果可能特别有用。
BACKGROUND: On January 20, 2020, a new coronavirus epidemic with human-to-human transmission was officially declared by the Chinese government, which caused significant public panic in China. In light of the coronavirus disease 2019 outbreak, pregnant women may be particularly vulnerable and in special need for preventive mental health strategies. Thus far, no reports exist to investigate the mental health response of pregnant women to the coronavirus disease 2019 outbreak.OBJECTIVE: This study aimed to examine the impact of coronavirus disease 2019 outbreak on the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women across China.STUDY DESIGN: A multicenter, cross-sectional study was initiated in early December 2019 to identify mental health concerns in pregnancy using the Edinburgh Postnatal Depression Scale. This study provided a unique opportunity to compare the mental status of pregnant women before and after the declaration of the coronavirus disease 2019 epidemic. A total of 4124 pregnant women during their third trimester from 25 hospitals in 10 provinces across China were examined in this cross-sectional study from January 1, 2020, to February 9, 2020. Of these women, 1285 were assessed after January 20, 2020, when the coronavirus epidemic was publicly declared and 2839 were assessed before this pivotal time point. The internationally recommended Edinburgh Postnatal Depression Scale was used to assess maternal depression and anxiety symptoms. Prevalence rates and risk factors were compared between the pre- and poststudy groups.RESULTS: Pregnant women assessed after the declaration of coronavirus disease 2019 epidemic had significantly higher rates of depressive symptoms (26.0% vs 29.6%, P=.02) than women assessed before the epidemic declaration. These women were also more likely to have thoughts of self-harm (P=.005). The depressive rates were positively associated with the number of newly confirmed cases of coronavirus disease 2019 (P=.003), suspected infections (P=.004), and deaths per day (P=.001). Pregnant women who were underweight before pregnancy, primiparous, younger than 35 years, employed full time, in middle income category, and had appropriate living space were at increased risk for developing depressive and anxiety symptoms during the outbreak.CONCLUSION: Major life-threatening public health events such as the coronavirus disease 2019 outbreak may increase the risk for mental illness among pregnant women, including thoughts of self-harm. Strategies targeting maternal stress and isolation such as effective risk communication and the provision of psychological first aid may be particularly useful to prevent negative outcomes for women and their fetuses.