深圳地区孕妇孕期抑郁与早产的关联性研究

The Correlation Between Maternal Depression and Preterm Birth in Shenzhen

目的探讨不同人群特征孕妇孕期抑郁与早产的关联性,为实现更有针对性的孕期抑郁心理保健提供依据。方法采用回顾性队列研究设计。研究对象于孕中期(13~27周)使用抑郁自评表(PHQ-9)进行孕期抑郁症状的评估,评分≥5分为抑郁诊断标准。通过深圳市妇幼保健管理信息系统收集一般人口学信息和妊娠结局。采用Cox风险比例模型分析孕期抑郁与早产的关联性。进一步按产妇年龄、户籍类型、教育程度和胎儿性别进行分层分析。结果共纳入7626名孕妇,孕期抑郁检出率为4.50%,早产发生率为5.3%,其中抑郁组孕妇早产发生率(7.6%)高于正常组(5.2%)。多因素Cox回归模型结果显示孕期抑郁显著增加早产的发生风险(HR=1.58,95%CI:1.06~2.36)。在亚组分析中,相比其他亚组,<35岁人群、深圳户籍、大学及以上学历和胎儿为女性的孕妇,其孕期抑郁与早产的关联性更加显著。结论孕期抑郁显著增加早产的风险,<35岁人群、深圳本地户籍、大学及以上学历和胎儿为女性的孕妇中由于孕期抑郁导致早产的可能性更大,应加强对这部分人群孕期抑郁的预防保健工作。

Objective To explore the correlation between maternal depression and preterm birth in different population groups,and provide evidence for targeted mental health care during pregnancy.Methods A retrospective cohort study was designed.Maternal depression symptoms were assessed by Patient Health Questionnaire-9(PHQ-9),and score≥5 was the diagnostic criteria for depression during pregnant metaphase(13-27 weeks).Socio-demographic variables and birth outcome were collected from Shenzhen Maternity and Child Healthcare Management Information System.Cox proportional hazard models were applied to analyze relationship between depression and preterm birth.Stratified analyses were conducted by age,resident status,education level and fetal sex.Results In all,7626 pregnant women were enrolled,and the detection rate of depression during pregnancy was 4.50%.Preterm birth rate in the study was 5.3%,and the rate in depression group(7.6%)was higher than that in normal group(5.2%).The result of multivariate Cox regression model showed that maternal depression significantly increased the risk of preterm birth(HR=1.58,95%CI:1.06-2.36).In subgroup analysis,the association between maternal depression and preterm birth was more significant in pregnancy age<35,residents,higher education level and female fetus subgroups.Conclusion Maternal depression significantly increases the risk of preterm birth.Maternal depression is more significantly associated with preterm birth in pregnancy age<35,resident status,higher education level and female fetus subgroups.More mental health care measures should be conducted in these populations.