母亲的忧郁症风险在产后一年时增加


  【24drs.com】根据一篇新研究,与产后立即进行的筛检结果相比,生产后6个月与12个月时重复进行产后忧郁(postpartum depression,PPD)筛检发现,13.5%妇女属于忧郁高风险。
  
  明尼苏达州罗彻斯特Olmsted医学中心研究部的Barbara P. Yawn医师等人在5/6月版的家庭医学志发表研究结果。
  
  虽然临床实务指引有许多其它相关的生育议题,Yawn医师等人指出,有关这些妇女之产后忧郁例行筛检的相关实证有限。作者们的资料来自「Translating Research Into Practice for Postpartum Depression study」这篇大型随机实用试验,纳入16州、接受生育或早期健康儿童保健的2,354名妇女。其中,1,432名妇女在产后当时的测量分数并未增加,这些妇女在产后6个月与12个月时再度接受调查。
  
  医师等人写道,汇整6个月与12个月时的筛检资料发现,所有产前评估分数小于等于10分的193名妇女的[病患健康问卷]分数上升。汇整6个月与12个月时的筛检资料,符合再度筛检的1,432名妇女有13.5%的产后忧郁风险高。
  
  作者们写道,分数倾向容易升高的妇女包括:有忧郁症病史、单身、中学肄业、焦虑;研究开始时的忧郁症状无法用来预测后续的检测分数升高。
  
  作者们提醒,他们的结果是根据产后忧郁筛检,而不是临床确认产后忧郁诊断,此外,收入较低与教育程度较低的妇女比较不会缴回问卷,再度筛检时的忧郁风险可能被低估了。
  
  作者们结论表示,对于有提供产后忧郁处理计画的诊所,根据这些研究结果,可以考虑在产后第一年重复筛检产后忧郁。
  
  资料来源:http://www.24drs.com/
  
  Native link:Moms' Depression Risk May Flare a Year After Giving Birth

Moms' Depression Risk May Flare a Year After Giving Birth

By Diedtra Henderson
Medscape Medical News

Repeating postpartum depression (PPD) screening at 6 and 12 months after childbirth revealed that 13.5% of women were newly at high risk for depression compared with their status when screened immediately after giving birth, according to a new study.

Barbara P. Yawn, MD, from the Olmsted Medical Center Department of Research, Rochester, Minnesota, and colleagues report the findings in an article published in the May/June issue of the Annals of Family Medicine.

Although clinical practice guidelines exist for many other maternity-related topics, Dr Yawn and coauthors note there is little evidence-based guidance regarding routine PPD screening for women. The authors tapped data from the Translating Research Into Practice for Postpartum Depression study, a large, randomized pragmatic trial that enrolled 2354 women in 16 states who received maternity or early well-child care. Of those, 1432 women had scores that were not elevated postpartum and were eligible to receive surveys again 6 and 12 months after giving birth.

"Together the 6- and 12-month repeated screenings yielded 193 women with elevated [Patient Health Questionnaire] scores who had scores of less than 10 on all prior postpartum assessments," Dr Yawn and colleagues write. "In aggregate the 6- and 12-month screenings identified 13.5% of the 1,432 women eligible for rescreening as being at high risk of having postpartum depression."

Women were more likely to have newly elevated scores if they had a history of depression, were single, had not completed high school, and were anxious. Baseline depressive symptoms, the authors write, are "not useful for predicting later elevated levels."

The authors caution that their results rely on PPD screening, rather than a clinically confirmed diagnosis of PPD. In addition, as women with lower income and less education were less likely to return the questionnaires, the depression risk on rescreening may be underestimated.

"For clinics that have an on-site PPD management program in place, repeated PPD screening during the first postpartum year should be considered based on these results," the authors conclude.

The Agency for HealthCare Research and Quality provided financial support for the study. The authors have disclosed no relevant financial relationships.

Ann Fam Med. 2015;13:228-234.

    
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