Maternal Psychological Symptom Trajectories From 2 to 24 Months Postpartum: A Latent Class Growth Analysis.
Maternal Psychological Symptom Trajectories From 2 to 24 Months Postpartum: A Latent Class Growth Analysis.
复制标题
产后 2 至 24 个月的母亲心理症状轨迹：潜在类别增长分析。
DOI：
10.1097/nnr.0000000000000713
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发表时间：
2024
期刊：
影响因子：
2.5
通讯作者：
Yang,Qing
中科院分区：
文献类型：
--
作者：
Scroggins,JihyeKim;Reuter-Rice,Karin;Brandon,Debra;Yang,Qing
研究背景产后妇女经历一系列与不良健康行为和结局相关的心理症状，包括产后自杀意念和长期抑郁。为了提供产后心理症状的早期管理，重要的是要了解症状经历如何随着时间的推移而变化。这项研究的目的是检查产妇心理症状的轨迹超过2，6，15，使用潜在类别增长分析，研究每个轨迹与24个月时母亲抑郁结果的相关性。家庭生活项目（N= 1，122），并进行了多轨迹潜在的类生长分析的基础上观察到的四个症状变量（抑郁，焦虑，躯体化和敌意）。确定最终模型后，进行双变量分析，以检查每个轨迹和（a）个人特征和（B）结果（中心流行病学研究抑郁量表[CES-D]）variables.ResultsA四类模型被选为最终模型，因为它有更好的拟合指数，熵，和可解释性之间的关联。四种症状轨迹为（a）24个月内无症状，（B）24个月内症状较轻，（c）15个月内症状中度加重，（d）24个月内症状重度加重。产后症状在24个月内增加的轨迹（轨迹4）中，经济地位低（92.16%）、失业（68.63%）或未完成4年大学教育（98.04%）的妇女更多。大多数产后妇女（95.56%）在轨迹4也有较高的CES-D截止分数，表明可能的临床抑郁症在24个月postparty.DiscussionPostpartum妇女经历增加症状轨迹超过15-24个月（轨迹3和4）可以受益于定制的症状管理干预措施提供早期在产后期间，以防止持续和恶化的症状的经验。
BackgroundPostpartum women experience an array of psychological symptoms that are associated with adverse health behaviors and outcomes including postpartum suicidal ideation and long-term depression. To provide early management of postpartum psychological symptoms, it is important to understand how the symptom experiences change over time.ObjectiveThe aim of this study was to examine maternal psychological symptom trajectories over 2, 6, 15, and 24 months postpartum using latent class growth analysis and to examine how each trajectory is associated with maternal depression outcome at 24 months.MethodsWe used secondary data from the Family Life Project (N= 1,122) and performed multitrajectory latent class growth analysis based on four observed symptom variables (depression, anxiety, somatization, and hostility). After the final model was identified, bivariate analyses were conducted to examine the association between each trajectory and (a) individual characteristics and (b) outcome (Center for Epidemiologic Studies Depression Scale [CES-D]) variables.ResultsA four-class model was selected for the final model because it had better fit indices, entropy, and interpretability. The four symptom trajectories were (a) no symptoms over 24 months,(b) low symptoms over 24 months,(c) moderate symptoms increasing over 15 months, and (d) high symptoms increasing over 24 months. More postpartum women with the trajectory of high symptoms increasing over 24 months (Trajectory 4) were in low economic status (92.16%), unemployed (68.63%), or did not complete 4-year college education (98.04%). Most postpartum women (95.56%) in Trajectory 4 also had higher CES-D cutoff scores, indicating a possible clinical depression at 24 months postpartum.DiscussionPostpartum women who experience increasing symptom trajectories over 15–24 months (Trajectories 3 and 4) could benefit from tailored symptom management interventions provided earlier in the postpartum period to prevent persistent and worsening symptom experiences.