Unintended Birth, Fetal and Infant Loss and Maternal Depressive Symptoms

意外分娩、胎儿和婴儿流产以及产妇抑郁症状

• 批准号: 8535181
• 负责人: PAMELA J SURKAN
• 金额: $ 7.69万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8535181
• 关键词: Accounting; Age; Age-Months; Area; Bangladesh; Birth; Caring; Censuses; Cessation of life; Child; Data; Developed Countries; Developing Countries; Development; Documentation; Employee Strikes; Enrollment; Epidemiologic Studies; Evaluation; Event; Fetal Death; Fetus; Foundations; Future; Gender; Geographic Locations; Goals; High Prevalence; Infant; Intervention; Intervention Studies; Link; Live Birth; Low income; Medical; Mental Depression; Mental Health; Mental disorders; Micronutrients; Monitor; Mothers; National Institute of Child Health and Human Development; Neonatal; Odds Ratio; Outcome; Parents; Perinatal; Perinatal mortality demographics; Personal Satisfaction; Planned Pregnancy; Population; Postpartum Depression; Postpartum Period; Postpartum Women; Pregnancy; Pregnancy Outcome; Pregnancy loss; Pregnant Women; Prevalence; Randomized; Reporting; Research; Research Design; Research Priority; Risk; Risk Factors; Rural; Sampling; Screening procedure; Son; South Asian; Spontaneous abortion; Statistical Methods; Suicide; Supplementation; Symptoms; Term Birth; Third Pregnancy Trimester; Time; Vital Status; Woman; base; boys; child bearing; cohort; depressive symptoms; disability; experience; fetal; girls; improved; insight; interest; neonatal death; offspring; population based; postnatal; preference; prenatal risk factor; reproductive; response; rural area; stillbirth; stressor; therapy design; unintended pregnancy

DESCRIPTION (provided by applicant): Depression is the most prevalent mental health disorder and globally is two times more likely to occur in women. In rural areas of Bangladesh, women's autonomy in planning pregnancy and the likelihood of successful pregnancy remain uncertain, with stillbirth, perinatal and neonatal death occurring at over five-fold higher rates than in developed countries. These rates are likely to be higher for rural women with little access to medical care. Our aims are to study: 1) the relation of unintended pregnancy to maternal depressive symptoms in the third trimester of pregnancy and at six months postpartum; 2) the relation of unintended pregnancy and fetal and neonatal loss to postpartum maternal depressive symptoms; 3a) whether the relation of unintended pregnancy with postpartum maternal depressive symptoms differs by gender of the offspring; and 3b) whether the relation of fetal or neonatal loss with postpartum maternal depressive symptoms differs by gender of the offspring. Miscarriage, stillbirth, perinatal death, and neonatal death will be examined separately as risk factors. The proposed secondary analysis uses data from a population-based, randomized antenatal micronutrient supplementation trial conducted from 2001 to 2007 in northwestern rural Bangladesh among ~60,000 pregnant women. Women were enrolled in early gestation and followed through 6 months postpartum. Pregnancy outcomes and infant vital status were monitored weekly through 3 months of age. In the third trimester and at 6 months, symptoms of depression were elicited by maternal responses to questions about common depressive symptoms as well as about suicide. Statistical methods will include descriptive analyses and calculation of adjusted risk ratios to examine unintended pregnancy and fetal and neonatal death events as predictors of subsequent depressive symptoms. We will assess the effects of pregnancy intent from each parent as well as discordance between maternal and paternal pregnancy intentions on maternal depressive symptoms. Documentation of unintended pregnancy and loss of a fetus or infant as risk factors for depressive symptoms in a large South Asian population will help to show their extent and guide interventions relevant to a vulnerable period when maternal mental health is critical for the healthy development of her other children.

描述（由申请人提供）：抑郁症是最普遍的心理健康障碍，在全球范围内，女性发生的可能性是男性的两倍。在孟加拉国农村地区，妇女在计划怀孕方面的自主权和成功怀孕的可能性仍然不确定，死产、围产期和新生儿死亡率比发达国家高五倍以上。这些比率在几乎得不到医疗照顾的农村妇女中可能更高。我们的目标是研究：1）妊娠晚期和产后6个月时意外怀孕与母亲抑郁症状的关系; 2）意外怀孕和胎儿及新生儿丢失与产后母亲抑郁症状的关系; 3a）意外怀孕与产后母亲抑郁症状的关系是否因后代的性别而异;和3b）胎儿或新生儿丢失与产后母亲抑郁症状的关系是否因后代的性别而不同。流产、死产、围产期死亡和新生儿死亡将作为风险因素单独进行检查。拟议的二次分析使用了2001年至2007年在孟加拉国西北部农村地区进行的基于人群的随机产前微量营养素补充试验的数据，其中约有60，000名孕妇。 妇女在妊娠早期入组，并随访至产后6个月。每周监测妊娠结局和婴儿生命状态，直至3个月大。在妊娠晚期和6个月时，母亲对常见抑郁症状和自杀问题的反应引发了抑郁症状。统计方法将包括描述性分析和调整后的风险比计算，以检查意外怀孕和胎儿和新生儿死亡事件作为随后的抑郁症状的预测因子。我们将评估每个父母的怀孕意图的影响，以及母亲和父亲的怀孕意图之间的不一致对母亲抑郁症状。记录非预期怀孕和胎儿或婴儿丢失作为南亚大规模人群中抑郁症状的风险因素，将有助于显示其程度，并指导与脆弱时期相关的干预措施，此时孕产妇心理健康对其他儿童的健康发育至关重要。

项目成果

Parental relationship satisfaction in French young adults associated with alcohol abuse and dependence.

法国年轻人的父母关系满意度与酒精滥用和依赖有关。

• DOI: 10.1016/j.addbeh.2011.10.008
• 发表时间: 2012
• 期刊: Addictive behaviors
• 影响因子: 4.4
• 作者: Surkan,PamelaJ;Fielding-Miller,Rebecca;Melchior,Maria
• 通讯作者: Melchior,Maria

Unintended pregnancy is a risk factor for depressive symptoms among socio-economically disadvantaged women in rural Bangladesh.

意外怀孕是孟加拉国农村社会经济弱势妇女出现抑郁症状的一个危险因素。

• DOI: 10.1186/s12884-018-2097-2
• 发表时间: 2018
• 期刊: BMC pregnancy and childbirth
• 影响因子: 3.1
• 作者: Surkan,PamelaJ;Strobino,DonnaM;Mehra,Sucheta;Shamim,AbuAhmed;Rashid,Mahbubur;Wu,LeeShu-Fune;Ali,Hasmot;Ullah,Barkat;Labrique,AlainB;Klemm,RolfDW;WestJr,KeithP;Christian,Parul
• 通讯作者: Christian,Parul