Association of antenatal depression with adverse consequences for the mother and newborn in rural Ghana: findings from the DON population-based cohort study.
Association of antenatal depression with adverse consequences for the mother and newborn in rural Ghana: findings from the DON population-based cohort study.
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DOI：
10.1371/journal.pone.0116333
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Kirkwood BR
中科院分区：
文献类型：
--
作者：
Weobong B;ten Asbroek AH;Soremekun S;Manu AA;Owusu-Agyei S;Prince M;Kirkwood BR
虽然有令人信服的证据表明死产的风险增加了近2倍，并且有证据表明患有精神障碍的母亲的后代死亡率增加，但只有三项研究讨论了产前抑郁症（AND）对婴儿生存的作用。我们在加纳的一个大型孕妇队列中研究了这些关联。在加纳金坦波卫生研究中心研究区，对所有育龄妇女进行4周监测，以确定怀孕情况并收集出生和死亡数据，开展了一项队列研究。使用患者健康问卷（PHQ-9）对女性进行AND筛查，以确定DSM-IV重度或轻度抑郁症。结局为不良出生结局、孕产妇/婴儿发病率和关键新生儿护理实践的采用，使用logistic回归进行检查;效应量报告为相对风险和95%置信区间。20 679名（89.6%）孕妇完成了PHQ-9。AND的患病率为9.9%（n = 2032）（95%置信区间为9.4%-10.2%）。 并且与：分娩时间过长（RR 1.25，95% CI 1.02-1.53）;围产期并发症（RR 1.11，95% CI 1.07-1.15）;产后并发症（RR 1.27，96% CI 1.21-1.34）;非阴道分娩（RR 1.19，95% CI 1.02-1.40）;新生儿疾病（RR 1.52，95%CI 1.16-1.99）;怀孕期间使用蚊帐（RR 0.93，95%CI 0.89-0.98），但不包括新生儿死亡、死产、低出生体重、立即开始母乳喂养或纯母乳喂养。AND与早产轻微相关（RR 1.32，95% CI 0.98-1.76）。本文提供了重要的证据，产前抑郁症的作用，作为一个潜在的贡献者，孕产妇和婴儿的发病率。建议立即采取以初级保健提供结构为基础的非药物治疗。我们进一步建议，试验的目的是评估是否治疗产前抑郁症与提高产科护理质量的结果在改善孕产妇和新生儿的结果。
Whilst there is compelling evidence of an almost 2-fold increased risk of still births, and suggestive evidence of increased mortality among offspring of mothers with psychotic disorders, only three studies have addressed the role of antenatal depression (AND) on survival of the baby. We examined these associations in a large cohort of pregnant women in Ghana. A Cohort study nested within 4-weekly surveillance of all women of reproductive age to identify pregnancies and collect data on births and deaths in the Kintampo Health Research Centre study area of Ghana. Women were screened for AND using the Patient Health Questionnaire (PHQ-9) to ascertain DSM-IV major or minor depression. Outcomes were adverse birth outcomes, maternal/infant morbidity, and uptake of key newborn care practices, examined using logistic regression; effect sizes reported as relative risks with 95% confidence intervals. 20679 (89.6%) pregnant women completed the PHQ-9. The prevalence of AND was 9.9% (n = 2032) (95% confidence interval 9.4%–10.2%). AND was associated with: prolonged labour (RR 1.25, 95% CI 1.02–1.53); peripartum complications (RR 1.11, 95% CI 1.07–1.15);postpartum complications (RR 1.27, 96% CI 1.21–1.34); non-vaginal delivery (RR 1.19, 95% CI 1.02–1.40); newborn illness (RR 1.52, 95% CI 1.16–1.99); and bed net use during pregnancy (RR 0.93, 95% CI 0.89–0.98), but not neonatal deaths, still births, low birth weight, immediate breast feeding initiation, or exclusive breastfeeding. AND was marginally associated with preterm births (RR 1.32, 95% CI 0.98–1.76). This paper has contributed important evidence on the role of antenatal depression as a potential contributor to maternal and infant morbidity. Non-pharmacological treatments anchored on primary care delivery structures are recommended as an immediate step. We further recommend that trials are designed to assess if treating antenatal depression in conjunction with improving the quality of obstetric care results in improved maternal and newborn outcomes.
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影响因子：
--
作者：
Grote, Nancy K.;Bridge, Jeffrey A.;Gavin, Amelia R.;Melville, Jennifer L.;Iyengar, Satish;Katon, Wayne J.
通讯作者：
Katon, Wayne J.
影响因子：
10.5
作者：
ADERIBIGBE, YA;GUREJE, O;OMIGBODUN, O
通讯作者：
OMIGBODUN, O
影响因子：
4.5
作者：
Ferri, Cleusa P.;Mitsuhiro, Sandro S.;Barros, Marina C. M.;Chalem, Elisa;Guinsburg, Ruth;Patel, Vikram;Prince, Martin;Laranjeira, Ronaldo
通讯作者：
Laranjeira, Ronaldo
DOI：
10.4088/jcp.08m04651
发表时间：
2009-09
期刊：
The Journal of clinical psychiatry
影响因子：
--
作者：
Bodnar LM;Wisner KL;Moses-Kolko E;Sit DK;Hanusa BH
通讯作者：
Hanusa BH
影响因子：
0.5
作者：
Kroenke, K;Spitzer, RL
通讯作者：
Spitzer, RL