• 作者：Marta Blasco Alonso ; ^{martacanaria@hotmail.com} ; Carolina Monedero Mora ; Javier Alcalde Torres ; Cristina Criado Santaella ; Fermí ; n Criado Enciso ; Mair Abehsera Bensabat
• 关键词：Depresió ; n posparto ; Depresió ; n perinatal ; Ansiedads
• 刊名：Progresos de Obstetricia y Ginecolog铆a
• 出版年：2008
• 期刊代码：pca294_03045013
• 类别：med
• 出版时间：June 2008
• 卷：51
• 期：6
• 页码：334-341
• 文件大小：96 K

Objectives

To understand perinatal depression, identify risk factors for depression during pregnancy, recognize depression during pregnancy, describe the possible links between depression and pregnancy, discover whether this disease affects the newborn, pregnancy or childbirth, and analyze treatment for depression during pregnancy.

Material and methods

We performed an observational, descriptive, prospective study of 118 pregnant women followed-up in the Obstetrics and Gynecology Psychosomatic Unit of the Maternity Hospital of Malaga for anxiety, depression or psychopharmacological treatment.

Results

A history of depression was found in 30%of the patients and a history of anxiety disorder in 9%. Among the patients treated, 63 had depression, 106 had anxiety (56 with depression), and nine had stress (five with anxiety and four with anxiety and depression). Sixty percent had one previous delivery and 40%had had one or more abortions (32%were voluntary). Pregnancy terminated in vaginal delivery in 66%, cesarean section in 28%, miscarriage in 4%, abortion in 2%, and preterm delivery in 16%(a frequency higher than in the general population, corroborating the literature on the subject). Of preterm deliveries, 5%were vaginal deliveries and 11%were cesarean sections. Treatment for depression consisted of antidepressant drugs in 63%(51%with paroxetine, 9%with fluoxetine and 3%with sertraline). Among patients treated for anxiety, 91%received an anxiolytic agent during the pregnancy. Only 11%rejected their newborns: 31%due to preterm delivery, 31%due to maternal depression, 15%due to severe cardiac defects, 7.5%due to the death of the husband, 7.5%due to death of the second twin, and 7.5%due to major problems with the partner.

Conclusions

The factors associated with a greater risk of anxiety or depression in pregnancy were as follows: age more than 30 years old, being a secundipara and having a prior abortion, a history of depression, difficulties in the relationship with the partner, being a housewife or working in the catering trade or hotel industry, undergoing an invasive technique during pregnancy, and hospital stay due to hyperemesis. The effects of anxiety and depression are more negative for the fetus than those of drug treatment for these disorders.