Treatment Initiation for New Episodes of Depression in Pregnant Women
孕妇新发抑郁症的治疗启动
基本信息
- 批准号:10402247
- 负责人:
- 金额:$ 66.29万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-05-06 至 2026-03-31
- 项目状态:未结题
- 来源:
- 关键词:AccountingAcupuncture TherapyAntidepressive AgentsBenefits and RisksBirthBlood flowBreast FeedingCessation of lifeCharacteristicsComplementary and alternative medicineDataDecision MakingDepression screenDoseEmotionalEpidemiologic MethodsGoalsImmunosuppressionInfantInternetInterventionLow Birth Weight InfantMaternal BehaviorMediator of activation proteinMental DepressionMental HealthObservational StudyOutcomePatternPerinatalPersonsPharmaceutical PreparationsPhototherapyPopulationPositioning AttributePostpartum PeriodPredictive FactorPregnancyPregnancy ComplicationsPregnant WomenPremature BirthProblem behaviorProviderPsychotherapyPublishingRandomized Controlled TrialsRecurrenceRiskRisk FactorsSelf CareSelf-Injurious BehaviorSeveritiesSiteSmall for Gestational Age InfantSmokingSupport GroupsSurveysSymptomsWomanYogaantenatalantepartum depressionbaseclinical decision-makingcomorbiditydemographicsdepressive symptomsethnic diversityexperiencehealth dataimprovedinfant outcomeinstrumentmaternal comorbiditymaternal depressionnoveloffspringpeer supportperinatal outcomesracial diversityresponsescreeningsubstance usetreatment effecttreatment optimization
项目摘要
PROJECT SUMMARY
Up to 12% of pregnant women have a new episode of depression, ie, an incident or recurrent depressive
episode with symptom onset during pregnancy. Effects of untreated antenatal depression include unhealthy
maternal behaviors (eg, diminished self-care, smoking, substance use, self-harm) and emotional and
behavioral problems in offspring. Antenatal depression or elevated depression scores, identified by screening
instruments, increase the risk of preterm birth (PTB), low birth weight (LBW), and small for gestational age
(SGA) birth, and are associated with breastfeeding discontinuation before 3 months postpartum. In-person
psychotherapy and antidepressant medication improve depression symptoms in many with depression, yet
<50% of pregnant women with new episodes of depression initiate these treatments. Although some barriers to
initiating antidepressants and psychotherapy are known, other factors have not been well described, especially
after accounting for depression severity. Furthermore, the impact of antidepressants and psychotherapy on
perinatal outcomes, including PTB, LBW, SGA, and breastfeeding continuation among pregnant women with
new episodes of depression after accounting for confounding by depression severity is unknown.
Given the importance of factors influencing the decision to initiate antidepressant or psychotherapy treatment
during pregnancy and the need for further evidence on the perinatal risks and benefits associated with
antidepressant use and psychotherapy in pregnant women, the goal of this study is to identify predictors and
perinatal effects of psychotherapy and antidepressant use for new episodes of depression during pregnancy
while accounting for depression severity. We will conduct this study in a racially and ethnically diverse multi-
site population using electronic health data, enriched with survey data from a subset of women.
Among pregnant women with new episodes of depression, we will evaluate factors that influence the
propensity to initiate psychotherapy or antidepressants; accounting for these is crucial when studying treatment
effects. We will describe patterns of use of alternative depression management approaches (eg, Internet-
based psychotherapy, peer support groups, and complementary and alternative medicine) and will evaluate
whether initiation of psychotherapy or antidepressants is associated with these practices while accounting for
depression severity. We will quantify the impact of psychotherapy and antidepressants (including dose, timing,
and duration of use) on PTB, LBW, SGA, and breastfeeding continuation accounting for the propensity to
initiate psychotherapy or antidepressants and depression severity.
We are uniquely positioned to overcome limitations of confounding and small size in prior studies given our
data on depression severity and maternal comorbidity for more than 8,000 pregnant women. Our study will be
informative for understanding the mental health interventions utilized by pregnant women with depression and
will inform decision making on optimal depression management during pregnancy.
项目摘要
多达12%的孕妇有一个新的抑郁症发作,即,事件或经常性抑郁症
怀孕期间症状发作的发作。未经治疗的产前抑郁的影响包括不健康
孕产妇行为(例如,自我保健,吸烟,吸烟,使用,自我伤害)和情感
后代的行为问题。通过筛查确定的产前抑郁症或抑郁得分升高
仪器,增加早产(PTB),低出生体重(LBW)的风险,胎龄很小
(SGA)出生,并且与产后3个月前的母乳喂养有关。面对面
心理疗法和抗抑郁药可改善许多患有抑郁症的抑郁症状
<50%的抑郁症发作的孕妇启动了这些治疗。虽然有些障碍
启动抗抑郁药和心理治疗是已知的,其他因素尚未得到很好的描述,尤其是
考虑到抑郁症的严重程度后。此外,抗抑郁药和心理治疗对
围产期结局,包括PTB,LBW,SGA以及孕妇的母乳喂养延续
考虑到抑郁严重程度混淆后,新的抑郁症发作尚不清楚。
鉴于影响决定启动抗抑郁药或心理治疗的因素的重要性
在怀孕期间,需要进一步证明与
孕妇抗抑郁药的使用和心理治疗,这项研究的目的是确定预测因子和
心理治疗和抗抑郁药在怀孕期间的新事件的围产期作用
同时考虑抑郁症的严重程度。我们将以种族和种族多样的多种多样的多样性进行这项研究
使用电子健康数据的现场人群,并充满了女性子集的调查数据。
在具有新的抑郁症发作的孕妇中,我们将评估影响的因素
启动心理疗法或抗抑郁药的倾向;在研究治疗时,考虑这些问题至关重要
效果。我们将描述替代抑郁管理方法的使用模式(例如,互联网 -
基于心理治疗,同伴支持小组以及补充和替代医学),并将评估
心理治疗或抗抑郁药的开始是否与这些实践相关
抑郁严重程度。我们将量化心理疗法和抗抑郁药的影响(包括剂量,时机,
PTB,LBW,SGA和母乳喂养持续的使用持续时间延续了倾向
启动心理治疗或抗抑郁药和抑郁严重程度。
在我们
超过8,000名孕妇的抑郁严重程度和孕产妇合并症的数据。我们的研究将是
了解抑郁症和
将为怀孕期间最佳抑郁管理的决策提供信息。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Kristin Palmsten其他文献
Kristin Palmsten的其他文献
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{{ truncateString('Kristin Palmsten', 18)}}的其他基金
Maternal COVID-19 Vaccination and Lactation Outcomes
孕产妇 COVID-19 疫苗接种和哺乳结果
- 批准号:
10650285 - 财政年份:2022
- 资助金额:
$ 66.29万 - 项目类别:
Maternal COVID-19 Vaccination and Lactation Outcomes
孕产妇 COVID-19 疫苗接种和哺乳结果
- 批准号:
10770308 - 财政年份:2022
- 资助金额:
$ 66.29万 - 项目类别:
Maternal COVID-19 Vaccination and Lactation Outcomes
孕产妇 COVID-19 疫苗接种和哺乳结果
- 批准号:
10390754 - 财政年份:2022
- 资助金额:
$ 66.29万 - 项目类别:
Treatment Initiation for New Episodes of Depression in Pregnant Women
孕妇新发抑郁症的治疗启动
- 批准号:
10612412 - 财政年份:2021
- 资助金额:
$ 66.29万 - 项目类别:
Oral Corticosteroid Use During Pregnancy and Risk for Preterm Birth
怀孕期间口服皮质类固醇的使用和早产风险
- 批准号:
9514312 - 财政年份:2017
- 资助金额:
$ 66.29万 - 项目类别:
Oral Corticosteroid Use During Pregnancy and Risk for Preterm Birth
怀孕期间口服皮质类固醇的使用和早产风险
- 批准号:
9754218 - 财政年份:2017
- 资助金额:
$ 66.29万 - 项目类别:
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