先兆早产孕妇抑郁与唾液皮质醇浓度的相关性研究

Association between depression and salivary cortisol among pregnant women with threatened preterm labor

目的了解先兆早产孕妇的抑郁和唾液皮质醇浓度,探讨两者间的相关性。方法共纳入138例先兆早产孕妇作为研究对象。采用爱丁堡产后抑郁量表(Edinburgh Postpartum Depression Scale,EPDS)测量其抑郁状况,同时收集8am、16pm、23pm的唾液进行皮质醇浓度检测。以EPDS≥9. 5分为界值,将研究对象分为抑郁组和非抑郁组。采用独立样本t检验比较两组唾液皮质醇浓度,采用Pearson相关分析抑郁和唾液皮质醇浓度的相关性。结果先兆早产孕妇的抑郁平均得分为(8. 8±4. 97)分。抑郁(EPDS≥9. 5分)检出率为46. 4%。8am、16pm、23pm的唾液皮质醇浓度分别为(14. 07±7. 36) ng/m L、(9. 27±5. 03) ng/m L、(5. 71±3. 92) ng/m L。总研究对象的EPDS与8amSC (r=0. 257,P=0. 002)、16pmSC (r=0. 303,P <0. 001)存在相关;非抑郁组孕妇的EPDS与8amSC (r=0. 306,P=0. 008)、16pmSC (r=0. 203,P=0. 048)存在相关。结论先兆早产孕妇抑郁者比例较高。抑郁与唾液皮质醇存在中低度相关性。产科医护人员应关注先兆早产孕妇的心理健康状况,即使是抑郁相对较轻者,也要帮助其改善抑郁状况以获得良好的妊娠结局。

Objectives To discover the depression status and salivary- eortisol （SC） level among women with threatened preterm labor, and find their associations. Methods 138 pregnant women with threatened preterm labor were re- cruited in this study. Edinburgh Postpartum Depression Scale （EPDS） was applied to assess women＇s depression, and their saliva were collected at 8am, 16pm, 23pm to test the eortisol level. EPDS ≥9. 5 was set as the cut-off value to assign the participants to depressive group （EPDS ≥9. 5） and non-depressive group （EPDS 〈 9. 5）. Independent samples t-test was used to compare the difference of salivary- eortisol of the two groups, and Pearson correlation analysis was also applied to calculated the associations between depression and salivary- eortisol. Results The average scores of EPDS in total women were （ 8.8± 4. 97 ）. The incidence of depression （ EPDS ≥ 9.5 ） was as high as 46.4 %. The average level of salivaryeortisol at 8am, 16pm and 23pm were （14.07 ±7. 36） ng/mL, （9.27 ±5.03） ng/mL and （5.71 ±3.92） ng/mL respectively. EP- DS in total women was associated with 8amSC （ r = 0. 257, P = 0. 002） and 16pmSC （ r = 0. 303, P 〈 0. 001 ）. EPDS in non-depressive group were also associated with 8amSC （ r = 0. 306, P = 0. 008 ） and 16pmSC （ r = 0. 203, P = 0. 048）. Conclusion Women with threatened preterm labor have a high incidence of depression. There was a low-moderate level of association between maternal depression and salivary- eortisol. Obstetrical doctors and nurses should focus on maternal psychological health level in women with threatened preterm labor. Even those individuals comparatively with a less severe depression, we need help them to minimize the severity of depression to achieve satisfying pregnant outcomes.