妊娠晚期抑郁与胎儿体重发育的关联研究

Association of maternal depression in late pregnancy with fetal weight development

目的探讨妊娠晚期抑郁情绪与新生儿出生体重间的关系,验证两者关系是否受分娩时孕周及新生儿性别调节。方法以1 800例在孕32~36周进行产前检查的孕妇作为研究对象,使用自制调查表和流调中心用抑郁自评量表,收集研究对象的社会人口学统计学信息并进行抑郁症状评价。分娩后获得分娩孕周、新生儿出生体重、性别等出生结局。结果控制潜在混杂因素后,对于足月孕产妇,妊娠晚期抑郁组与非抑郁组的新生儿出生体重差异无统计学意义,但早产孕产妇,妊娠晚期抑郁组的新生儿出生体重显著低于非抑郁组,差异有统计学意义(P=0.003)。以无妊娠晚期抑郁孕妇分娩的男婴为对照,妊娠晚期抑郁孕妇分娩的男婴小于胎龄儿(SGA)发生风险无显著增加(OR=0.86,95%CI:0.20~3.76),而妊娠晚期抑郁孕妇分娩的女婴SGA风险显著增加(OR=4.37,95%CI:2.08~9.18)。结论孕32~36周高水平抑郁情绪可能显著减少早产儿出生体重,特别是女婴出生体重。

Objective To assess the association between prenatal depressive symptoms in the third trimester and birth weight and examine whether gestational weeks and fetal gender mediates this association. Methods The data on maternal sociodemographic characteristics and depressive symptoms were measured in 1 800 pregnant women during 32 - 36 gestational weeks. Birth outcomes were prospectively collected through medical records. Results There were no significant difference on birth weight in term infants between depressive mother in late pregnancy and non-depressive mother. However, the birth weight in premature infants of depressive mother in late pregnancy was significantly lower than that in premature infants of non-depressive mother （ P = 0. 003 ）. Compared with male in- fants non-depressive mother, the risk of SGA significantly increased among female infants of depressive mother in late pregnancy （OR =4. 37, 95% CI： 2. 08 - 9. 18）, but not in male infants of depressive mother （OR = 0. 86, 95% CI： 0. 20- 3.76）. Conclusion The depressive symptoms in late pregnancy might significantly reduced the birth weight in premature infants, especially in female infants.