摘要
目的 了解孕产妇围生期抑郁动态变化特征,分析其与新生儿生长发育异常的相关性.方法 采用巢氏病例对照研究设计对2021年5月至2023年5月在临平区建卡和分娩的母婴于孕早期、孕中期、孕晚期和产后42天进行4次随访,利用爱丁堡产后抑郁量表(EPDS)和发育进程问卷系统调查母亲抑郁转归和子代生长发育状况,分析孕产期抑郁动态变化与新生儿生长发育情况的关联性.结果 共招募210对母婴,孕早期、孕中期、孕晚期和产后抑郁检出率分别为39.52％、21.90％、15.71％、25.24％.异常组的孕产妇孕中期抑郁检出率高于正常组,差异有统计学意义(x2=4.29,P=0.04);孕中期EPDS量表评分高于正常组,差异有统计学意义(P=0.03).广义估计方程分析结果显示,孕早期、孕中期、孕晚期和产后EPDS量表得分均与婴儿生长发育呈负相关(P=0.04).结论 孕早期、孕中期、孕晚期和产后抑郁症状对新生儿生长发育有负面影响,应在孕期及产后积极开展健康指导,降低母亲抑郁症状发生.
Abstract
Objectives Understanding the Dynamic Changes in Perinatal Depression in Pregnant Women and Ana-lyzing their Correlation with Abnormal Newborn Growth and Development.Methods A nested case-control study design was employed to conduct four follow-up visits on mothers and infants who were registered and delivered in Linping District from May 2021 to May 2023 during early,middle,late pregnancy,and 42 days postpartum.The Edinburgh Postnatal Depression Scale(EPDS)and a developmental progress questionnaire system were used to assess maternal depression status and offspring growth and development.Based on the growth and development of the offspring,they were divided into normal and abnormal groups.The detection rates of maternal depression and EPDS scores during early,middle,late pregnancy,and postpartum were compared between the two groups,and the association between the dynamic changes in perinatal depression and newborn growth and development was analyzed.Results The study recruited a total of 210 mother-infant pairs,with depression detec-tion rates during early,middle,late pregnancy,and postpartum being 39.52％,21.90％,15.71％,and 25.24％,respectively.The detection rate of depression during the middle pregnancy period was higher in the abnormal group compared to the normal group,and the difference was statistically significant(x2=4.29,P=0.04).EPDS scores during the middle pregnancy period were also higher in the abnormal group compared to the normal group,with a statistically significant difference(P=0.03).The results of generalized estimating equation analysis showed that EPDS scores during early,middle,late pregnancy,and post-partum were all negatively associated with infant growth and development(P=0.04).Conclusion Depression symptoms during early,middle,late pregnancy,and postpartum have a negative impact on newborn development.Therefore,proactive health guidance should be provided during pregnancy and postpartum to reduce the occurrence of maternal depression symptoms.
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