期刊
JOURNAL OF WOMENS HEALTH
卷 24, 期 5, 页码 384-393出版社
MARY ANN LIEBERT, INC
DOI: 10.1089/jwh.2014.4857
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资金
- Boston University Reproductive, Perinatal, and Pediatric Epidemiology Training Grant from the Eunice Kennedy Shriver National Institute for Child Health and Human Development [T32HD052458]
- Centers for Disease Control and Prevention (CDC) [1U38OT000143-02]
Background: Understanding the influence of perinatal stressors on the prevalence of postpartum depressive symptoms (PDS) and help-seeking for PDS using surveillance data can inform service provision and improve health outcomes. Methods: We used Massachusetts Pregnancy Risk Assessment Monitoring System (MA-PRAMS) 2007-2010 data to evaluate associations between selected perinatal stressors and PDS and with subsequent help-seeking behaviors. We categorized 12 stressors into 4 groups: partner, traumatic, financial, and emotional. We defined PDS as reporting always or often to any depressive symptoms on PRAMS Phase 5, or to a composite score >= 10 on PRAMS Phase 6 depression questions, compared with women reporting sometimes, rarely or never to all depressive symptoms. The median response time to MA-PRAMS survey was 3.2 months (interquartile range, 2.9-4.0 months). We estimated prevalence ratios (PRs) and 95% confidence intervals (95% CIs) using modified Poisson regression models, controlling for socioeconomic status indicators, pregnancy intention and prior mental health visits. Results: Among 5,395 participants, 58% reported >= 1 stressor (partner=26%, traumatic=16%, financial=29% and emotional=30%). Reporting of >= 1 stressor was associated with increased prevalence of PDS (PR=1.68, 95% CI: 1.42-1.98). The strongest association was observed for partner stress (PR=1.90, 95% CI: 1.51-2.38). Thirty-eight percent of mothers with PDS sought help. Mothers with partner-related stressors were less likely to seek help, compared with mothers with other grouped stressors. Conclusions: Women who reported perinatal common stressors-particularly partner-related stressors-had an increased prevalence of PDS. These data suggest that women should be routinely screened during pregnancy for a range of stressors and encouraged to seek help for PDS.
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