Depression in Pregnancy and the Postpartum Period

妊娠期和产后抑郁症

• 批准号: 7099732
• 负责人: KORAY TANFER
• 金额: $ 15.84万
• 依托单位: BATTELLE CENTERS/PUB HLTH RES & EVALUATN
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-01-01 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7099732
• 关键词: Depression; Pregnancy; Postpartum; Period

DESCRIPTION (provided by applicant): Perinatal depression is thought to affect a considerable portion of pregnant and postpartum women, creating a public health event with a large population at risk. Untreated, it can have long-term, negative consequences for the woman, her child, and family. Much past research on the prevalence and incidence of perinatal depression and its risk factors has two important limitations: (a) it is largely based on narrowly defined, homogeneous samples; and (b) it has relied on screening tools to assess perinatal depression without confirming the diagnosis. This makes past results vulnerable to dispute. The proposed research provides a cost-effective approach to overcoming the limitations. We will provide more accurate incidence and prevalence estimates than have previously been available for a diverse group of women, better identify risk factors for perinatal depression, and for the first time examine how characteristics of a woman's place of residence are related to her perinatal depression risks. Specifically, we will: (1) Estimate the prevalence and incidence of major and minor depressive episodes at the beginning of the third trimester of pregnancy, and at two weeks and six months postpartum, including estimates by age, race, education, income, marital status, and parity. (2) Estimate, net of other characteristics, the relationships between psychosocial characteristics, including personal and family history of mood disorders and family stressors, and the likelihood of experiencing major and/or minor depression symptoms at each of the three points in time. (3) Estimate, the net effect of pregnancy intention, delivery method and complications on the likelihood of experiencing depression at the three points in time. (4) Estimate the relationships between community characteristics of women's place of residence (e.g., types and availability of health care resources and providers, social, economic, and demographic composition of the community, and the normative environment governing health care seeking behaviors) and the likelihood of experiencing depression at each of the three points in time. We propose to collect data from a larger and more diverse sample of women than in prior U.S. studies of perinatal depression, and to validate a diagnosis of depression at each point in time with the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) for the women who score above an established level on the Edinburgh Postnatal Depression Scale. We will use these data to estimate incidence and prevalence to address Specific Aim 1 and to estimate multivariate models to address Specific Aims 2-4.

描述（由申请人提供）：围产期抑郁症被认为影响相当一部分孕妇和产后妇女，造成大量人口面临风险的公共卫生事件。如果不加以治疗，可能会给妇女、她的孩子和家庭带来长期的负面影响。过去许多关于围产期抑郁症的患病率和发病率及其危险因素的研究有两个重要的局限性：（a）它主要基于狭隘定义的同质样本； (b) 它依赖筛查工具来评估围产期抑郁症，但没有确诊。这使得过去的结果很容易引起争议。拟议的研究提供了一种具有成本效益的方法来克服这些限制。我们将为不同的女性群体提供比以前更准确的发病率和患病率估计，更好地识别围产期抑郁症的危险因素，并首次研究女性居住地的特征与其围产期抑郁症风险的关系。具体来说，我们将：（1）估计妊娠晚期开始时以及产后两周和六个月时重性和轻性抑郁发作的患病率和发生率，包括按年龄、种族、教育程度、收入、婚姻状况和胎次进行估计。 (2) 扣除其他特征后，估计心理社会特征之间的关系，包括情绪障碍和家庭压力源的个人和家族史，以及在三个时间点中的每个时间点经历严重和/或轻微抑郁症状的可能性。 (3) 估计怀孕意愿、分娩方式和并发症对三个时间点出现抑郁的可能性的净影响。 (4) 估计妇女居住地的社区特征（例如，医疗保健资源和提供者的类型和可用性、社区的社会、经济和人口构成，以及管理就医行为的规范环境）与在三个时间点中的每一个点经历抑郁的可能性之间的关系。我们建议从比美国之前的围产期抑郁症研究更大、更多样化的女性样本中收集数据，并通过 DSM-IV-TR 轴 I 障碍结构化临床访谈 (SCID-I) 验证每个时间点对爱丁堡产后抑郁量表得分高于既定水平的女性的抑郁症诊断。我们将使用这些数据来估计发病率和患病率，以解决具体目标 1，并估计多变量模型以解决具体目标 2-4。