The relationship between parental stress and postpartum depression among adolescent mothers enrolled in a randomized controlled prevention trial.
The relationship between parental stress and postpartum depression among adolescent mothers enrolled in a randomized controlled prevention trial.
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DOI：
10.1007/s10995-013-1394-7
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发表时间：
2014-08
影响因子：
2.3
通讯作者：
Zlotnick C
中科院分区：
文献类型：
--
作者：
Venkatesh KK;Phipps MG;Triche EW;Zlotnick C
鉴于抑郁和父母压力在青春期母亲中高度共现，我们评估了初产青春期母亲中父母压力与产后抑郁之间的关系。我们对106名青少年母亲进行了一项观察性分析，这些母亲参加了一项预防产后抑郁症的随机对照试验，共289次产后就诊。父母的压力是用父母压力指数来衡量的。采用DSM-IV儿童诊断的结构化临床访谈来评估产后抑郁症；阈下抑郁采用修订版儿童抑郁评定量表进行评估。采用广义估计方程评估产后前6个月父母压力与产后抑郁的关系。我们提出了校正优势比（AOR），控制了研究组、年龄、在美国出生、既往抑郁症史和研究访问次数。中位年龄为16岁，53%为拉丁裔，16%报告有抑郁症病史。19名青少年（19%）被诊断为产后抑郁症，25%的人在产后6个月内经历了高水平的父母压力。报告父母压力水平较高的青春期母亲患产后抑郁症的风险显著增加[AOR 1.06 (95% CI 1.04-1.09)；P < 0.0001]。高水平的父母压力预示着随后的产后抑郁，在抑郁症诊断前评估就诊时的父母压力，以确定我们是否可以建立时间关联[AOR 1.06 (95% CI 1.02 - 1.09)；P < 0.01]。父母压力也是阈下抑郁的危险因素[AOR 1.04 (95% CI 1.01 - 1.07)；P < 0.01]。父母压力是青春期母亲发生产后抑郁和阈下抑郁的重要危险因素。以减轻父母压力为目标的干预措施可能会减轻初产少女母亲的抑郁严重程度。
Given the high co-occurrence of depression and parental stress among adolescent mothers, we evaluated the relationship between parental stress and postpartum depression among primiparous adolescent mothers. We conducted an observational analysis among a cohort of 106 adolescent mothers at 289 postpartum visits who were enrolled in a randomized controlled trial to prevent postpartum depression. Parental stress was measured using the Parenting Stress Index, short form. The Structured Clinical Interview for DSM-IV Childhood Diagnoses was administered to assess for postpartum depression; subthreshold depression was assessed using the Children's Depression Rating Scale, revised version. Generalized estimating equations were utilized to assess the relationship of parental stress on postpartum depression during the first 6 months postpartum. We present adjusted odds ratios (AOR) controlling for study arm, age, born in the United States, prior history of depression, and number of study visits. The median age was 16 years, 53 % were Latina, and 16 % reported a past history of depression. Nineteen adolescents (19 %) were diagnosed with postpartum depression and 25 % experienced high levels of parental stress through 6 months postpartum. Adolescent mothers who reported higher levels of parental stress were at significantly increased risk for postpartum depression [AOR 1.06 (95 % CI 1.04–1.09); p < 0.0001]. High levels of parental stress predicted subsequent postpartum depression when assessing parental stress at visits prior to a depression diagnosis to determine whether we could establish a temporal association [AOR 1.06 (95 % CI 1.02– 1.09); p < 0.01]. Parental stress was also a risk factor for subthreshold depression [AOR 1.04 (95 % CI 1.01– 1.07); p < 0.01]. Parental stress was a significant risk factor for developing both postpartum depression as well as subthreshold depression among adolescent mothers. Interventions that target a reduction in parental stress may lead to less depression severity among primiparous adolescent mothers.