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增强产前护理模型和产后抑郁症:EMBRACE随机临床试验

Jennifer N Felder^1,2, Daisy León-Martínez³, Deborah Karasek⁴

¹Department of Psychiatry and Behavioral Sciences, University of California, San Francisco.

JAMA network open

|February 16, 2026

概括

增强的团体产前护理 (eGPC) 和增强的个人产前护理 (eIPC) 均减少了围产期抑郁症状. 在这项针对低收入孕妇的研究中,两种护理模式之间没有发现显著差异.

科学领域:

围产期健康围产期健康
心理健康差异的差异
健康的社会决定因素

背景情况:

种族,种族和收入差异导致围产期抑郁症的流行率和治疗差距.
针对健康的社会决定因素的有效干预对于母亲的心理健康至关重要.

研究的目的:

为了比较增强群体产前护理 (eGPC) 与增强个人产前护理 (eIPC) 在减少围产期抑郁症状方面的有效性.
调查eGPC是否为孕产妇的心理健康提供了比eIPC更好的结果.

主要方法:

这是一项随机临床试验,涉及加利福尼亚州圣若aquin山谷10家诊所的674名低收入孕妇.
参与者被随机分配到eGPC (包括社会支持服务) 或eIPC (个性化心理社会评估).
从基线到产后3个月,使用患者健康问卷-9 (PHQ-9) 测量抑郁症状.

主要成果:

无论是eGPC和eIPC组,从基线到产后3个月,抑郁症症状严重程度的统计显著降低.
在eGPC和eIPC组之间没有观察到抑郁症状减少的显著差异 (科恩d = 0.1;P = .45).
在这两种护理模式中,参与者在母亲的心理健康中经历了适度的改善.

结论:

增强的团体产前护理和增强的个人产前护理都在改善产周期间抑郁症状方面是有效的.
该研究没有发现任何证据表明,一种增强产前护理模式在减少围产期抑郁症方面比另一种更有效.
研究结果强调了综合性产前护理的重要性,该护理应对母亲心理健康的社会决定因素.

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