Unintended Birth, Fetal and Infant Loss and Maternal Depressive Symptoms

意外分娩、胎儿和婴儿流产以及产妇抑郁症状

基本信息

批准号：
8302689
负责人：
PAMELA J SURKAN
金额：
$ 8.1万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2014-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8302689
关键词：
Accounting Age Age-Months Area Bangladesh Birth Caring Censuses Cessation of life Child Data Developed Countries Developing Countries Development Documentation Employee Strikes Enrollment Epidemiologic Studies Evaluation Event Fetal Death Fetus Foundations Future Gender Geographic Locations Goals High Prevalence Infant Intervention Intervention Studies Link Live Birth Low income Medical Mental Depression Mental Health Mental disorders Micronutrients Monitor Mothers National Institute of Child Health and Human Development Neonatal Odds Ratio Outcome Parents Perinatal Perinatal mortality demographics Personal Satisfaction Planned Pregnancy Population Postpartum Depression Postpartum Period Postpartum Women Pregnancy Pregnancy Outcome Pregnancy loss Pregnant Women Prevalence Randomized Reporting Research Research Design Research Priority Risk Risk Factors Rural Sampling Screening procedure Son South Asian Spontaneous abortion Statistical Methods Suicide Supplementation Symptoms Term Birth Third Pregnancy Trimester Time Vital Status Woman base boys child bearing cohort depressive symptoms disability experience fetal girls improved insight interest neonatal death offspring population based postnatal preference prenatal risk factor reproductive response rural area stillbirth stressor therapy design unintended pregnancy

项目摘要

DESCRIPTION (provided by applicant): Depression is the most prevalent mental health disorder and globally is two times more likely to occur in women. In rural areas of Bangladesh, women's autonomy in planning pregnancy and the likelihood of successful pregnancy remain uncertain, with stillbirth, perinatal and neonatal death occurring at over five-fold higher rates than in developed countries. These rates are likely to be higher for rural women with little access to medical care. Our aims are to study: 1) the relation of unintended pregnancy to maternal depressive symptoms in the third trimester of pregnancy and at six months postpartum; 2) the relation of unintended pregnancy and fetal and neonatal loss to postpartum maternal depressive symptoms; 3a) whether the relation of unintended pregnancy with postpartum maternal depressive symptoms differs by gender of the offspring; and 3b) whether the relation of fetal or neonatal loss with postpartum maternal depressive symptoms differs by gender of the offspring. Miscarriage, stillbirth, perinatal death, and neonatal death will be examined separately as risk factors. The proposed secondary analysis uses data from a population-based, randomized antenatal micronutrient supplementation trial conducted from 2001 to 2007 in northwestern rural Bangladesh among ~60,000 pregnant women. Women were enrolled in early gestation and followed through 6 months postpartum. Pregnancy outcomes and infant vital status were monitored weekly through 3 months of age. In the third trimester and at 6 months, symptoms of depression were elicited by maternal responses to questions about common depressive symptoms as well as about suicide. Statistical methods will include descriptive analyses and calculation of adjusted risk ratios to examine unintended pregnancy and fetal and neonatal death events as predictors of subsequent depressive symptoms. We will assess the effects of pregnancy intent from each parent as well as discordance between maternal and paternal pregnancy intentions on maternal depressive symptoms. Documentation of unintended pregnancy and loss of a fetus or infant as risk factors for depressive symptoms in a large South Asian population will help to show their extent and guide interventions relevant to a vulnerable period when maternal mental health is critical for the healthy development of her other children. PUBLIC HEALTH RELEVANCE: The proposed research takes advantage of a large population-based supplementation trial conducted among pregnant and postpartum women in rural Bangladesh. Our goal is to better understand unintended pregnancy, fetal and neonatal loss, and child gender as predictors of maternal depressive symptoms. Ultimately, identification of risk factors for prenatal and postpartum depressive symptoms will inform screening procedures, future epidemiological studies and intervention design and evaluation.

描述（由申请人提供）：抑郁症是最普遍的精神健康疾病，在全球范围内，女性患抑郁症的可能性是女性的两倍。在孟加拉国农村地区，妇女计划怀孕的自主权和成功怀孕的可能性仍然不确定，死产、围产期和新生儿死亡率比发达国家高五倍多。对于几乎无法获得医疗服务的农村妇女来说，这一比例可能更高。我们的目标是研究：1）意外怀孕与妊娠晚期和产后六个月母亲抑郁症状的关系； 2）意外怀孕以及胎儿和新生儿丢失与产后母亲抑郁症状的关系； 3a) 意外怀孕与产后母亲抑郁症状的关系是否因后代性别而异； 3b) 胎儿或新生儿丢失与产后母亲抑郁症状的关系是否因后代性别而异。流产、死产、围产期死亡和新生儿死亡将作为危险因素单独检查。拟议的二次分析使用了 2001 年至 2007 年在孟加拉国西北部农村地区约 60,000 名孕妇进行的一项基于人群的随机产前微量营养素补充试验的数据。女性在妊娠早期就被纳入研究，并在产后 6 个月内进行随访。每周监测妊娠结局和婴儿生命状态直至 3 个月大。在妊娠晚期和六个月时，母亲对常见抑郁症状和自杀问题的回答引发了抑郁症状。统计方法将包括描述性分析和调整风险比的计算，以检查意外怀孕以及胎儿和新生儿死亡事件，作为随后抑郁症状的预测因子。我们将评估父母双方怀孕意愿的影响以及母亲和父亲怀孕意愿之间的差异对母亲抑郁症状的影响。将意外怀孕和胎儿或婴儿丢失作为大量南亚人口抑郁症状的危险因素进行记录，将有助于显示其严重程度，并指导与脆弱时期相关的干预措施，此时母亲的心理健康对其其他孩子的健康发展至关重要。孩子们。公共卫生相关性：拟议的研究利用了在孟加拉国农村地区的孕妇和产后妇女中进行的一项大规模的基于人群的补充试验。我们的目标是更好地了解意外怀孕、胎儿和新生儿丢失以及儿童性别作为孕产妇抑郁症状的预测因素。最终，产前和产后抑郁症状危险因素的识别将为筛查程序、未来的流行病学研究以及干预设计和评估提供信息。