Perinatal complications increase the risk of postpartum depression. The Generation R Study
Perinatal complications increase the risk of postpartum depression. The Generation R Study
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DOI：
10.1111/j.1471-0528.2010.02660.x
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发表时间：
2010-10-01
影响因子：
5.8
通讯作者：
Tiemeier, H.
中科院分区：
文献类型：
--
作者：
Blom, E. A.;Jansen, P. W.;Tiemeier, H.
Objectiveinvestigationwhether specific pregnancy and delivery complications are risk factors for postpartum depressosit.DesignA prospective longitudinal study.SettingRotterdam，Netherlands.PopulationA cohort of 4941 pregnancy women who enrolled in the Generation R Study.MethodsInformation on peripheral complications were obtained from the midwife and hospital registrations or by questionnaire. Logistic回归分析被用来计算产后抑郁症的风险为单独的围产期complications.Main结果measuresPostpartum精神症状进行了评估2个月后交付使用爱丁堡产后抑郁量表。先兆子痫（校正OR，aOR 2.58，95% CI 1.30-5.14），妊娠期间住院（aOR 2.25，95% CI 1.19-4.26），急诊剖宫产（aOR 1.53，95% CI 1.02-2.31），疑似胎儿窘迫（aOR 1.56，95% CI 1.08-2.27），产科医生提供的医学指征分娩（aOR 2.43，95%CI 1.56-3.78）和婴儿入院（aOR 1.45，95%CI 1.10-1.92）。在调整混杂因素（如既存精神病理学症状和社会人口学特征）后，计划外妊娠、血栓形成、羊水粪染和Apgar评分与产后抑郁无关。产后抑郁症的风险增加围产期并发症的妇女经历的数量（P < 0.001）。ConclusionsWe表明，几个怀孕和分娩并发症提出了妇女的心理健康在产后期间的风险。产科医生，助产士，全科医生，以及婴儿诊所的工作人员应该意识到，经历过围产期并发症的妇女，特别是那些有一些围产期并发症的妇女，有患产后抑郁症的风险。
ObjectiveTo examine whether specific pregnancy and delivery complications are risk factors for postpartum depression.DesignA prospective longitudinal study.SettingRotterdam, the Netherlands.PopulationA cohort of 4941 pregnant women who enrolled in the Generation R Study.MethodsInformation on perinatal complications was obtained from the midwife and hospital registries or by questionnaire. Logistic regression analyses were used to calculate the risk of postpartum depression for the separate perinatal complications.Main outcome measuresPostpartum psychiatric symptoms were assessed 2 months after delivery using the Edinburgh postnatal depression scale.ResultsSeveral perinatal complications were significantly associated with postpartum depression, namely: pre-eclampsia (adjusted OR, aOR 2.58, 95% CI 1.30-5.14), hospitalization during pregnancy (aOR 2.25, 95% CI 1.19-4.26), emergency caesarean section (aOR 1.53, 95% CI 1.02-2.31), suspicion of fetal distress (aOR 1.56, 95% CI 1.08-2.27), a medically indicated delivery provided by an obstetrician (aOR 2.43, 95% CI 1.56-3.78), and hospital admission of the baby (aOR 1.45, 95% CI 1.10-1.92). Unplanned pregnancy, thrombosis, meconium-stained amniotic fluid, and Apgar score were not associated with postpartum depression after adjustment for confounding factors, such as pre-existing psychopathological symptoms and sociodemographic characteristics. The risk of postpartum depression increased with the number of perinatal complications women experienced (P < 0.001).ConclusionsWe showed that several pregnancy and delivery complications present a risk for women's mental health in the postpartum period. Obstetricians, midwives, general practitioners, and staff at baby well clinics should be aware that women who experienced perinatal complications-especially those with a number of perinatal complications-are at risk for developing postpartum depression.