【罂粟摘要】硬膜外分娩镇痛与产后抑郁之间的关系：前瞻性队列研究
硬膜外分娩镇痛与产后抑郁之间的关系：前瞻性队列研究
10％至15％的妇女受产后抑郁症（PPD）的影响，且造成了社会经济负担以及影响孕产妇疾病发生率。最近的研究表明，硬膜外镇痛可能与PPD的发展有关，但是这种联系尚无定论。
探讨围产期人口学、镇痛及心理因素与产后抑郁症的关系。
前瞻性，多种族纵向队列研究。
新加坡的公共生育机构。
招募新加坡产科医院在产前和产后3个月进行咨询的孕妇。
无。
产后3个月采用爱丁堡产后抑郁量表评估产后抑郁的主要结局，以探讨硬膜外分娩镇痛与产后抑郁的关系。此外，还评估了产后抑郁症与妊娠26周时焦虑和抑郁的关系。分析人口学、镇痛、心理因素及产时资料。
共有651名妇女，其中152例（23.3%）为产后抑郁症，499例（76.7%）为非产后抑郁者。硬膜外镇痛组（95/385，24.7%）与未接受硬膜外镇痛组（57/266，21.4%）（未调整比值比1.20，95%可信区间0.83-1.75，P=0.3361）产后3个月的PPD发生率无显著性差异。产前焦虑和抑郁与产后3个月产后抑郁呈正相关。
分娩后3个月PPD的发生与硬膜外分娩镇痛之间无相关性。
Investigating the association between labour epidural analgesia and postpartum depression: A prospective cohort study
BACKGROUND Postpartum depression (PPD) affects 10 to 15% of women and is associated with socio-economic burden and maternal morbidity. Recent studies showed that epidural analgesia may be associated with the development of PPD, although this association remains inconclusive.
OBJECTIVE To investigate the role of perinatal demographic, analgesic and psychological factors that may be related to PPD.
DESIGN Prospective, longitudinal multiethnic cohort study.
SETTING Singapore’s two major public maternity institutions.
PATIENTS Pregnant women recruited during antenatal consultation and with follow-up 3 months postdelivery at Singapore hospitals with maternity services.
INTERVENTION None.
MAIN OUTCOME MEASURES The primary outcome of PPD was assessed 3 months postdelivery using the Edinburgh Postnatal Depression Scale to investigate an association with the use of labour epidural analgesia. The associations between PPD and anxiety and depression at 26 weeks’ gestation predelivery were also evaluated. Demographic, analgesic, psychological factors and intrapartum data were analysed.
RESULTS There were 651 women with 152 cases (23.3%) of PPD and 499 controls (76.7%) at 3 months after child-birth. There was no significant difference between women who received labour epidural analgesia (95 of 385, 24.7%) and those who did not receive epidural analgesia (57 of 266,21.4%) (unadjusted odds ratio 1.20, 95% confidence interval 0.83 to 1.75, P=0.3361) in the incidence of PPD 3 months postdelivery. Predelivery anxiety and depression were positively associated with PPD 3 months postdelivery.
CONCLUSION Our study did not demonstrate an association between PPD at 3 months postdelivery and labour epidural analgesia.
翻译：牛振瑛
编辑：佟睿
审校：曹莹