The Epidemiology of Hospitalized Postpartum Depression

描述(申请人提供)：尚未描述需要住院治疗的严重产后抑郁症的流行病学特征。根据现有的有限数据，住院的产后抑郁症约占所有病例的5%，在产妇年龄分布的极端情况下，似乎不成比例地困扰着社会经济上处于不利地位的妇女。然而，目前还没有关于严重产后抑郁症的频率及其发生模式与社会、人口、行为和婴儿健康特征相关的可靠估计。我们建议通过链接公开可用的数据资源，对纽约州众多不同人口中住院的产后抑郁症进行高效、全面和基于人群的评估。使用医院出院数据，我们将跟踪每个妇女在1995年至2004年期间在该州出生后的一年时间。通过将分娩和抑郁症出院记录联系起来，我们可以高度全面和准确地估计严重产后抑郁症的患病率和发病率。我们将把这些数据与2000年人口普查联系起来，以评估社区的社会经济和城市化因素，以及婴儿住院和死亡记录。有了这个独特的数据资源，我们将(1)通过确定与产妇社会人口学特征和地理位置有关的模式来描述住院产后抑郁症的流行病学；(2)检查婴儿健康与因产后抑郁症住院治疗之间的关系；以及(3)检查常见妊娠并发症(包括妊娠期糖尿病、先兆子痫和剖腹产)与因产后抑郁症住院治疗之间的关系。这项研究将通过确定预测因素和确定严重产后抑郁症高危人群的特征，为未来的病因学和干预研究提供必要的基础。与公共卫生相关：需要住院治疗的产后抑郁症是怀孕的一种潜在灾难性后果，对母亲和孩子都有不利影响，经常需要社会服务机构进行干预，为婴儿提供护理。此外，在这一关键时期中断母子关系可能会对儿童的认知和情感健康造成长期后果，这本身就会带来巨大的社会成本。通过清楚地确定发生的流行病学模式，这项研究将为设计和实施关于严重产后抑郁的社会、行为和生物医学原因的详细病因学研究提供必要的指导。

DESCRIPTION (provided by applicant): The epidemiological characteristics of severe postpartum depression requiring hospitalization have not been described. Based on the limited data available, hospitalized postpartum depression comprises approximately 5 percent of all cases and appears to disproportionately afflict socioeconomically disadvantaged women at the extremes of the maternal age distribution. However, a current and reliable estimate of the frequency of severe postpartum depression and its pattern of occurrence in relation to social, demographic, behavioral, and infant health characteristics is not available. We propose to conduct a highly efficient, yet comprehensive and population-based assessment of hospitalized postpartum depression in the large and diverse population of the State of New York by linking publicly available data resources. Using hospital discharge data, we will follow each woman forward in time for one year following births that occur in the state from 1995 through 2004. By linking delivery and depression hospital discharge records, we can estimate the prevalence and incidence of severe postpartum depression with a high degree of comprehensiveness and accuracy. We will link these data to the 2000 Census to evaluate neighborhood socioeconomic and urbanization factors, and infant hospitalization and death records. With this unique data resource, we will (1) Describe the epidemiology of hospitalized postpartum depression by identifying patterns in relation to maternal sociodemographic characteristics and geographic location; (2) Examine the relation between infant health and hospitalization for postpartum depression; and (3) Examine the relation between common complications of pregnancy, including gestational diabetes mellitus, preeclampsia, and cesarean delivery, and hospitalization for postpartum depression. This research will provide a needed basis on which to focus future etiologic and intervention research by identifying the predictors and defining the characteristics of those at highest risk for severe postpartum depression. PUBLIC HEALTH RELEVANCE: Postpartum depression requiring hospitalization is a potentially catastrophic consequence of pregnancy that adversely affects both the mother and the child and frequently necessitates the intervention of social services to provide care for the infant. Moreover, the interruption of mother-child bonding during this critical period may result in long term consequences for the child's cognitive and emotional well- being, which in itself carries a significant social cost. By clearly identifying the epidemiologic patterns of occurrence, this study will provide needed guidance regarding the design and conduct of detailed etiologic studies of the social, behavioral, and biomedical causes of severe postpartum depression.