Analysis Of Depressive Symptoms And Influencing Factors During Pregnancy

Objective:To analysis the influencing factors of depression during pregnancy and provide a reference for pregnant women’s psychological health care based on data from a multicenter prospective cohort study.Methods:Data were from the Chinese Pregnant Women Cohort Study(CPWCS).The study sites were distributed in 24 hospitals in 15 provinces.The research subjects were recruited from July 25,2017 to November 26,2018.A questionnaire survey was used to collect socio-demographic data and pregnancy history of pregnant women.Behavior and lifestyle,including sleeping time,dietary intake and physical activity,as well as depression in early,middle and late pregnancy were also collected.Univariable and multivariable Generalized Estimating Equation(GEE)were used to analyze the influencing factors of depression during pregnancy,and multivariable Logistic regression was used for sensitivity analysis.Results:1.The detection of depression during pregnancyThe detection rates of depression in early,middle and late pregnancy were 24.90%(2289/9193),21.91%(1225/5591)and 22.43%(966/4307),and the rate in the second trimester was lower than in the first and third trimesters.4139 pregnant women with complete depression information in early,middle and late pregnancy were included in the GEE model for analysis.Among them,248(5.99%)pregnant women detected depression in three trimesters,and 523(12.64%)pregnant women detected depression in two trimesters,and 999(24.14%)pregnant women detected depression in only one trimester.2.Influencing factors associated with depression during pregnancyRegarding social and demographic factors,detectable depression rate was relatively low among the pregnant women who were elder in age(25 years old～:OR=0.78,95%CI:0.67～0.91;30 years old～:OR=0.78,95%CI:0.65～0.94;≥35 years old:OR=0.73,95%CI:0.77～0.93),from ethnic minorities(OR=0.76,95%CI:0.59～0.99),normal in pre-pregnancy BMI(OR=0.80,95%CI:0.88～0.95),educated highest by senior middle schooling(OR=0.81,95%CI:0.66～0.99),employed(OR=0.87,95%CI:0.76～0.99)and having higher family income annually(OR=0.84,95%CI:0.72～0.98).Regarding pregnancy-related factors,detectable depression rate was relatively high among the pregnant women with unplanned pregnancies(OR=1.29,95%CI:1.15～1.45).Regarding behavior and lifestyle factors,detectable depression rate was relatively high among the pregnant women who had passive smoking(OR=1.25,95%CI:1.14～1.38)and alcoholic drinks(OR=1.51,95%CI:1.20～1.90).The rate of depression was relatively low among pregnant women who had longer sleeping time(6 hours～:OR=0.63,95%CI:0.52～0.76;≥8 hours:OR=0.42,95%CI:0.35～0.51).The rate of depression was also relatively low among those who,in diet,had fruits and vegetables(OR=0.67,95%CI:0.88～0.78),food of animal origin(OR=0.74,95%CI:0.65～0.85),milk and dairy products(OR=0.79,95%CI:0.71～0.87)up to dietary standards.While the rate of depression was relatively high among those having unhealthy food(OR=1.09,95%CI:1.01～1.23)and carbonated or sugary beverages(OR=1.11,95%CI:1.00～1.23).In terms of physical activity,the depression rate was relatively low among pregnant women who keep mid-high-level activities(OR=0.78,95%CI:0.70～0.87).Conclusions:Maternal age,BMI in pre-pregnancy,education level,working status,family income,unplanned pregnancy,passive smoking,drinking,sleeping time,physical activity,as well as consumption of vegetables or fruits,food of animal origin,milk and dairy products,unhealthy food,carbonated or sugared beverages were all influencing factors of depression during pregnancy.Avoiding passive smoking,not drinking,enough sleep,a healthy diet and mid-high-level of activities can reduce the risk of depression during pregnancy.