母親的憂鬱症風險在產後一年時增加


  【24drs.com】根據一篇新研究,與產後立即進行的篩檢結果相比,生產後6個月與12個月時重複進行產後憂鬱(postpartum depression,PPD)篩檢發現,13.5%婦女屬於憂鬱高風險。
  
  明尼蘇達州羅徹斯特Olmsted醫學中心研究部的Barbara P. Yawn醫師等人在5/6月版的家庭醫學誌發表研究結果。
  
  雖然臨床實務指引有許多其他相關的生育議題,Yawn醫師等人指出,有關這些婦女之產後憂鬱例行篩檢的相關實證有限。作者們的資料來自「Translating Research Into Practice for Postpartum Depression study」這篇大型隨機實用試驗,納入16州、接受生育或早期健康兒童保健的2,354名婦女。其中,1,432名婦女在產後當時的測量分數並未增加,這些婦女在產後6個月與12個月時再度接受調查。
  
  醫師等人寫道,彙整6個月與12個月時的篩檢資料發現,所有產前評估分數小於等於10分的193名婦女的[病患健康問卷]分數上升。彙整6個月與12個月時的篩檢資料,符合再度篩檢的1,432名婦女有13.5%的產後憂鬱風險高。
  
  作者們寫道,分數傾向容易升高的婦女包括:有憂鬱症病史、單身、中學肄業、焦慮;研究開始時的憂鬱症狀無法用來預測後續的檢測分數升高。
  
  作者們提醒,他們的結果是根據產後憂鬱篩檢,而不是臨床確認產後憂鬱診斷,此外,收入較低與教育程度較低的婦女比較不會繳回問卷,再度篩檢時的憂鬱風險可能被低估了。
  
  作者們結論表示,對於有提供產後憂鬱處理計畫的診所,根據這些研究結果,可以考慮在產後第一年重複篩檢產後憂鬱。
  
  資料來源: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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