Desirée Domacassé, Susanne R de Rooij, Tanja Vrijkotte, Ank de Jonge, Jens Henrichs
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引用次数: 0
Abstract
Objective: Maternal postpartum depressive and anxiety symptoms are risk factors for subsequent maternal and child mental health problems. Little is known about the potential role of antepartum vitamin D and C-reactive protein (CRP) in the etiology of maternal postpartum affective symptoms. We investigated associations between antepartum vitamin D status and postpartum depressive and anxiety symptoms and whether antepartum CRP mediated these associations.
Methods: In 2483 participants of the Amsterdam Born Children and their Development prospective cohort, maternal serum vitamin D and CRP were measured at a median of 13 weeks' gestation. Vitamin D status was defined as deficient (≤29.9 nM), insufficient (30-49.9 nM), sufficient (50-79.9 nM), or normal (≥80 nM). Maternal depressive symptoms (Center for Epidemiologic Studies-Depression) and anxiety (State-Trait Anxiety Inventory) were assessed 3 months postpartum.
Results: After adjustments for confounders, vitamin D deficiency was only associated with increased postpartum anxiety symptoms ( B = 0.17, 95% confidence interval [CI] = 0.03-0.30, p = .017) compared to normal vitamin D levels (≥80 nM). In women not taking vitamin D supplementation ( n = 2303), vitamin D deficiency was associated with increased postpartum depressive and anxiety symptoms ( B = 0.14, 95% CI = 0.03-0.28, p = .045; and B = 0.17, 95% CI = 0.03-0.32, p = .015). Antepartum CRP did not mediate these links.
Conclusions: We found some evidence that antepartum vitamin D deficiency was associated with increased postpartum affective symptoms, especially in women not taking vitamin D supplementation. Clinical trials should determine whether vitamin D supplementation can reduce the risk for postpartum affective disorders.
目的:产妇产后抑郁和焦虑症状是导致其后出现母婴心理健康问题的风险因素。人们对产前维生素 D 和 C 反应蛋白(CRP)在产妇产后情感症状病因中的潜在作用知之甚少。我们研究了产前维生素 D 状态与产后抑郁和焦虑症状之间的关系,以及产前 CRP 是否对这些关系起中介作用:方法:在阿姆斯特丹出生儿童及其发育前瞻性队列的 2483 名参与者中,在中位孕期 13 周时测量了母体血清维生素 D 和 CRP。维生素 D 状态被定义为缺乏(≤29.9 nM)、不足(30-49.9 nM)、充足(50-79.9 nM)或正常(≥80 nM)。产后 3 个月对产妇的抑郁症状(流行病学研究中心-抑郁症)和焦虑(状态-特质焦虑量表)进行评估:在对混杂因素进行调整后,与正常的维生素 D 水平(>80 nM)相比,维生素 D 缺乏仅与产后焦虑症状的增加有关(B = 0.17,95% CI [0.03,0.30],p = .017)。在未补充维生素 D 的妇女(n = 2 303)中,维生素 D 缺乏与产后抑郁和焦虑症状的增加有关(B = 0.14,95% CI 0.03,0.28,p = .045;B = 0.17,95% CI 0.03,0.32,p = .015)。产前 CRP 并不介导这些联系:我们发现一些证据表明,产前维生素 D 缺乏与产后情感症状的增加有关,尤其是在未补充维生素 D 的妇女中。临床试验应确定补充维生素 D 是否能降低产后情感障碍的风险。
期刊介绍:
Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society. The journal publishes experimental, clinical, and epidemiological studies on the role of psychological and social factors in the biological and behavioral processes relevant to health and disease. Psychosomatic Medicine is an interdisciplinary peer-reviewed journal devoted to high-quality science on biobehavioral mechanisms, brain-behavior interactions relevant to physical and mental disorders, as well as interventions in clinical and public health settings.
Psychosomatic Medicine was founded in 1939 and publishes interdisciplinary research articles relevant to medicine, psychiatry, psychology, and other health-related disciplines. The print journal is published nine times a year; most articles are published online ahead of print. Supplementary issues may contain reports of conferences at which original research was presented in areas relevant to the psychosomatic and behavioral medicine.