Identification of antenatal depression in obstetric care
Identification of antenatal depression in obstetric care
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DOI：
10.1007/s00404-011-1872-3
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发表时间：
2011-12-01
影响因子：
2.6
通讯作者：
Bitzer, Johannes
中科院分区：
文献类型：
--
作者：
Alder, Judith;Fink, Nadine;Bitzer, Johannes
产科护理中抑郁症的检出率普遍较低，许多妇女仍未得到诊断，也得不到充分的支助。在许多产科环境中，抑郁症的筛查工具并没有得到常规应用，因此非常需要提高医疗保健专业人员对抑郁症风险增加的患者的敏感性。本研究的目的是确定共同评估的患者特征，与产前depress.137妇女进行了筛选，使用爱丁堡产后抑郁量表（EPDS）在开始的第二孕期在门诊部的第三大学医院。如果分数高于12分的临界值，女性被认为是抑郁症的高危人群。从分娩后的患者档案中提取产科病史和结果。21%的样本筛选为抑郁症阳性。Logistic回归分析显示，妊娠期恶心、妊娠期（过早）宫缩和服用镇痛药的三联征显著预测高抑郁评分，阳性预测值为84.3%。抑郁症孕妇在怀孕期间定期服用镇痛药的相对风险是非抑郁症妇女的4倍，如果抑郁症筛查不是常规产前护理的一部分，则应针对本研究中确定的标记物患者进行抑郁症的系统评估。
Detection rates of depression in obstetric care are generally low, and many women remain undiagnosed and do not receive adequate support. In many obstetric settings, screening tools for depression are not applied routinely and there is a great need to sensitize health care professionals for the patient at risk for enhanced levels of depression. The present study aimed at identifying commonly assessed patient characteristics that are associated with antenatal depression.One hundred and thirty seven women were screened using the Edinburgh Postnatal Depression Scale (EPDS) at the beginning of the second trimester at the outpatient department of a Tertiary University Hospital. Women were identified as at high risk for depression if scores were above a cut-off score of twelve. Obstetric history and outcome were extracted from patient files after delivery.Twenty one percent of the sample screened as depression positive. Logistic regression with backwards elimination showed that the triad of nausea during pregnancy, reports of (premature) contractions and consumption of analgesics during pregnancy significantly predicted high depression scores with a positive predictive value of 84.3%. The relative risk for a depressed pregnant woman to regularly take analgesics during pregnancy was fourfold higher than for non-depressed women.If depression screening is not part of routine prenatal care, systematic assessment of depression should be targeted for patients presenting with the markers identified in this study.