Surkan Pamela J, Patel Shivani A, Rahman Atif
Social and Behavioural Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Health, Baltimore, USA.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA.
Best Pract Res Clin Obstet Gynaecol. 2016 Oct;36:156-168. doi: 10.1016/j.bpobgyn.2016.05.007. Epub 2016 Jun 24.
This review provides an overview of perinatal depression and its impacts on the health of mothers, their newborns, and young children in low- and middle-income countries (LMICs). We define and describe the urgency and scope of the problem of perinatal depression for mothers, while highlighting some specific issues such as suicidal ideation and decreased likelihood to seek health care. Pathways through which stress may link maternal depression to childhood growth and development (e.g., the hypo-pituitary axis) are discussed, followed by a summary of the adverse effects of depression on birth outcomes, parenting practices, and child growth and development. Although preliminary studies on the association between maternal depressive symptoms and maternal and child mortality exist, more research on these topics is needed. We describe the available interventions and suggest strategies to reduce maternal depressive symptoms in LMICs, including integration of services with existing primary health-care systems.
本综述概述了低收入和中等收入国家(LMICs)围产期抑郁症及其对母亲、新生儿和幼儿健康的影响。我们界定并描述了母亲围产期抑郁症问题的紧迫性和范围,同时强调了一些具体问题,如自杀意念和寻求医疗保健的可能性降低。讨论了压力可能将母亲抑郁症与儿童生长发育联系起来的途径(例如,下丘脑 - 垂体轴),随后总结了抑郁症对分娩结局、育儿方式以及儿童生长发育的不利影响。尽管已有关于母亲抑郁症状与母婴死亡率之间关联的初步研究,但仍需要对这些主题进行更多研究。我们描述了现有的干预措施,并提出了在低收入和中等收入国家减少母亲抑郁症状的策略,包括将服务与现有的初级卫生保健系统相结合。