Role of anxiety and depression in the onset of spontaneous preterm labor
Role of anxiety and depression in the onset of spontaneous preterm labor
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DOI：
10.1093/aje/155.4.293
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发表时间：
2002-02-15
影响因子：
5
通讯作者：
Thouin, A
中科院分区：
文献类型：
--
作者：
Dayan, J;Creveuil, C;Thouin, A
本研究于1997-1998年在法国进行，目的是调查产前焦虑和抑郁对自发性早产的影响。一个连续系列的634名孕妇与单胎妊娠。焦虑和抑郁进行了评估，使用自填式问卷：Spielberger的状态-特质焦虑量表和爱丁堡抑郁量表。抑郁评分被二分，以提示重度抑郁症的临界值为标准。第75百分位数用于焦虑评分。Logistic回归分析，控制社会人口学和生物医学因素，包括相互作用的条款，显示抑郁症与体重不足的妇女，定义为妇女孕前体重指数低于19（调整后的比值比（OR）= 6.9，95%置信区间（CI）：1.8，26.2）的结果呈正相关。在有早产史的女性中观察到类似的特质焦虑结果（调整后OR = 4.8，95%CI：1.1，20.4）。在阴道出血的女性中，这种关联与状态焦虑的显著性接近（调整后的OR = 3.6，95%CI：0.9，14.7）。这些发现表明，焦虑和抑郁，当结合特定的生物医学因素，与自发性早产。一个协同作用的心理和生物医学因素对胎盘促肾上腺皮质激素释放因子分泌的假设。
The aim of this cohort study conducted in France in 1997-1998 was to investigate the effects of antenatal anxiety and depression on spontaneous preterm labor. A consecutive series of 634 pregnant women with singleton pregnancies was included. Anxiety and depression were assessed using self-administered questionnaires: Spielberger's State-Trait Anxiety Inventory and the Edinburgh depression scale. Depression scores were dichotomized with a cutoff value suggestive of major depression. The 75th percentile was used for anxiety scores. A logistic regression analysis, controlling for sociodemographic and biomedical factors and including interaction terms, revealed that depression was positively associated with the outcome among underweight women, defined as women with a prepregnancy body mass index below 19 (adjusted odds ratio (OR) = 6.9, 95% confidence interval (CI): 1.8, 26.2). A similar result was observed for trait anxiety in women with a history of preterm labor (adjusted OR = 4.8, 95% CI: 1.1, 20.4). The association was close to significance for state anxiety in women with vaginal bleeding (adjusted OR = 3.6, 95% CI: 0.9, 14.7). These findings show that anxiety and depression, when combined with specific biomedical factors, are associated with spontaneous preterm labor. A synergic action of psychological and biomedical factors on the secretion of placental corticotropin-releasing factor is hypothesized.