母亲产后抑郁和婴儿免疫接种的完成:2006-2015年196,329对母婴的英国队列研究

H. C. Smith, S. Saxena, I. Petersen
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引用次数: 2

摘要

目的:探讨母亲产后抑郁与婴儿疫苗接种完成的关系。方法:我们使用健康改善网络(THIN)的数据进行了一项队列研究,这是一个大型的英国初级保健电子健康记录数据库。我们确定了196,329对母婴,其中婴儿在2006年至2015年间出生。产后抑郁症是通过抗抑郁药处方或产后第一年的诊断或抑郁症状来确定的。主要结局是1岁以下婴儿完成3次5合1疫苗接种;这种疫苗可以预防白喉、破伤风、百日咳、脊髓灰质炎和b型流感嗜血杆菌。我们使用泊松回归模型来比较有产后抑郁症记录的妇女的儿童与无产后抑郁症记录的妇女的儿童接种5合1疫苗的可能性。结果:196,329名妇女中,20,802名(10.6%)有产后抑郁和/或抗抑郁处方记录。有记录的母亲与无记录的母亲的婴儿5合1疫苗接种完成率无差异(校正发病率比[IRR] = 1.01;95% ci, 0.99-1.02)。与来自最贫困地区的儿童相比,来自社会更贫困地区的儿童完成婴儿疫苗接种的可能性更低(IRR = 0.92;95% ci, 0.90-0.93)。2014-2015年与2006-2007年相比,完成婴儿疫苗接种的可能性随着时间的推移而下降(IRR = 0.90;95% ci, 0.89-0.92)。结论:在接受初级保健的母亲中,母亲产后抑郁症与婴儿疫苗接种率较低无关,但需要更多的研究来得出结论,是否更严重的抑郁症或未被识别的抑郁症与较低的疫苗接种率有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Maternal Postnatal Depression and Completion of Infant Immunizations: A UK Cohort Study of 196,329 Mother-Infant Pairs, 2006-2015.
Objective: To examine the relationship between maternal postnatal depression and completion of infant vaccinations. Methods: We conducted a cohort study using data from The Health Improvement Network (THIN), a large UK primary care electronic health record database. We identified 196,329 mother-infant pairs in which the infant was born between 2006 and 2015. Postnatal depression was identified through antidepressant prescriptions or diagnoses or symptoms of depression in first year after childbirth. Primary outcome was completion of three 5-in-1 vaccination doses in infants before 1 year of age; this vaccine protects against diphtheria, tetanus, whooping cough, polio, and Haemophilus influenzae type b. We used Poisson regression models to compare likelihood of infant 5-in-1 vaccine uptake among children of women with a record of postnatal depression to likelihood among those without. Results: Of the 196,329 women, 20,802 (10.6%) had a record of postnatal depression and/or antidepressant prescription. There was no difference in infants' 5-in-1 vaccination completion between those of mothers with a record and those of mothers' without (adjusted incidence rate ratio [IRR]  = 1.01; 95% CI, 0.99-1.02). Those from more socially deprived areas were less likely to complete infant vaccinations compared to those from the least deprived areas (IRR = 0.92; 95% CI, 0.90-0.93). Likelihood of completing infant vaccination decreased over time, comparing 2014-2015 to 2006-2007 (IRR = 0.90; 95% CI, 0.89-0.92). Conclusions: Among mothers who engage with primary care, maternal postnatal depression is not associated with lower rates of infant vaccination, though more research is needed to conclude if either more severe depression or unrecognized depression is associated with lower completion rates.
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