产后抑郁症状与避孕措施之间的关联
Chloe N Matovina1, Allie Sakowicz2, Emma C Allen3
1Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL.
American journal of obstetrics and gynecology
|March 29, 2024
概括
严重的产后抑郁症状显著降低了分娩的可能性,人们选择任何避孕措施. 这突显了综合精神和生殖健康护理的急需,以支持明智的计划生育决策.
科学领域:
- 围产期心理健康问题
- 生殖健康 生殖健康
- 公共卫生 公共卫生
背景情况:
- 产后抑郁症 (PPD) 影响10-20%的分娩个体,影响医疗保健利用率.
- 人们对PPD症状与避孕选择之间的联系知之甚少.
- 未经治疗的抑郁症和短暂的妊娠间隔带来了显著的围产期风险.
研究的目的:
- 调查产后抑郁症状与关于避孕使用的决定之间的联系.
- 为了确定抑郁症状的严重程度是否会影响避孕选择.
主要方法:
- 在协作护理心理健康计划中,对1871名分娩个体 (2017-2022) 的回顾性队列研究.
- 使用患者健康问卷-9 (PHQ-9) 评估产后抑郁症状,按严重程度分层.
- 在电子健康记录中记录的避孕方法选择,如果在分娩和产后访问时被拒绝,则被二分为"没有".
主要成果:
- 8.5%的参与者患有中度严重或更严重的PPD (PHQ-9>14);2.3%患有严重的PPD (PHQ-9>19).
- 较高的PHQ-9分数与医学并发症,较高的BMI和非白人/西班牙裔种族相关.
- 抑郁症症状严重程度的增加与拒绝任何避孕方法 (严重症状的aOR为2.92) 有关.
结论:
- 严重的PPD症状与拒绝所有产后避孕措施有关.
- 鉴于目前对堕胎准入的威胁,这种联系至关重要,可能会增加意外怀孕.
- 综合性围产期心理健康和生殖服务对于支持避孕决策至关重要.
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