Perinatal depression and birth outcomes in a Healthy Start project.
Perinatal depression and birth outcomes in a Healthy Start project.
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DOI：
10.1007/s10995-010-0595-6
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发表时间：
2011-04
影响因子：
2.3
通讯作者：
Yonkers KA
中科院分区：
文献类型：
--
作者：
Smith MV;Shao L;Howell H;Lin H;Yonkers KA
考虑到抑郁症带来的围产期不良后果风险，卫生资源和服务管理局（HRSA）的妇幼保健局（MCHB）从2001年至2005年通过联邦健康开端倡议投入资源，对孕妇进行抑郁症筛查，并将其与服务联系起来。在这份报告中，我们提出了一个项目，筛选抑郁症，并提供服务的妇女在怀孕期间抑郁症状或精神痛苦，以评估该计划是否与出生低体重儿，小于胎龄儿，或早产儿的减少。在2001-2005年招募的三个队列中的1 100名妇女中检查了该方案的影响，其中包括：（1）在健康开端倡议开始之前招募的受试者;（2）在健康开端倡议中招募的受试者;（3）在项目期间招募但未在健康开端倡议中招募的对照组。调整协变量后，可能患有抑郁症的妇女比非抑郁症妇女早产的可能性高出1.5倍。与未入组Healthy Start的女性相比，入组Healthy Start的女性早产、低出生体重或小于胎龄儿的校正或未校正风险均显著降低。然而，无论健康开始计划的登记情况如何，在健康开始计划开始后分娩的妇女比在计划开始前分娩的妇女早产的可能性低85%。抑郁状态增加了不良出生结局的风险，参与健康开始计划并没有改变这些结果。我们不能排除这样的可能性，即健康开始计划的社群活动促进了对抑郁症妇女健康问题的关注，从而提高了生育结果。
Given the risk of adverse perinatal outcomes associated with a depressive disorder, the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) from 2001–2005 devoted resources through the Federal Healthy Start Initiative to screen pregnant women for depression and link them with services. In this report, we present the evaluation of a program that screened for depression and provided services for women with depressive symptoms or psychiatric distress in pregnancy to assess whether the program was associated with a reduction in babies born low birth weight, small for gestational age, or preterm. The program impact was examined among 1,100 women in three cohorts enrolled from 2001–2005 that included: (1) subjects recruited prior to the inception of the Healthy Start Initiative; (2) subjects enrolled in the Healthy Start Initiative; and (3) a comparison group recruited during the project period but not enrolled in the Healthy Start Initiative. After adjustment for covariates, women with probable depression were over one and a half times more likely to give birth to a preterm baby than non depressed women. Neither adjusted nor unadjusted risks for delivery of preterm, low birth weight or small for gestational age infants were significantly lower for women enrolled in Healthy Start as compared to women not enrolled in Healthy Start. However, regardless of enrollment in Healthy Start, women who delivered babies after the Healthy Start program began were 85% less likely to deliver preterm babies than women giving birth before the program began. Depression status conferred increased risk of adverse birth outcomes, results that were not altered by participation in the Healthy Start program. We cannot exclude the possibility that the community activities of the Healthy Start program promoted increased attention to health issues among depressed women and hence enhance birth outcomes.
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影响因子：
2.3
作者：
Salihu, Hamisu M.;Mbah, Alfred K.;Berry, Lo
通讯作者：
Berry, Lo
影响因子：
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作者：
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通讯作者：
Prince, CB
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作者：
Meschke, LL;Holl, JA;Messelt, S
通讯作者：
Messelt, S
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Andersson, L;Sundström-Poromaa, I;Bixo, M
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Bixo, M
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Hemmingsen, R