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DOI: 10.1055/s-0028-1109822
© Georg Thieme Verlag KG Stuttgart · New York
Prä-, peri- und postpartale Depressivität
Erste Erkenntnisse aus FRAMES (Franconian Maternal Health Evaluation Studies)Pre-, Peri- and Postpartal DepressionFirst Cognition from FRAMES (Franconian Maternal Health Evaluation Studies)Publication History
Publication Date:
26 October 2009 (online)
![](https://www.thieme-connect.de/media/fdn/200912/lookinside/thumbnails/10.1055-s-0028-1109822-1.jpg)
Zusammenfassung
Einleitung: Postpartale Depressionen sind mit 8 – 15 % sehr häufig auftretende mütterliche Erkrankungen nach der Geburt eines Kindes. Aufgrund der weitreichenden negativen Folgen für die Betroffenen und deren Familien wie Chronifizierung der Depression, sozialer Rückzug bis hin zu Verhaltensauffälligkeiten der Kinder, müssen Risikopatientinnen frühzeitig erkannt werden. Methoden: Im Rahmen einer prospektiven Studie (FRAMES: Franconian Maternal Health Evaluation Studies) wurden 1100 Frauen mithilfe standardisierter Fragebögen zu 3 Zeitpunkten befragt: präpartal ab der 30. SSW, 48 – 72 h postpartal (pp) und 6 – 8 Monate pp. Für das Teilprojekt Blue FRAMES konnten 554 Frauen gewonnen werden. Dabei fand eine zusätzliche telefonische Befragung am 10. pp Tag zu Symptomen des Baby Blues (Stimmungsschwankungen, Reizbarkeit, Konzentrationsstörungen) statt. Zur Ermittlung einer Depressivität und deren Schweregrad zu unterschiedlichen Zeitpunkten wurden die Edinburgh Postnatal Depression Scale (EPDS) und die Hamilton Rating Scale For Depression (HAMD) verwendet. Ergebnisse: Die Werte im EPDS-Fragebogen (Friedman Test; χ2 = 110,8; df = 2, p < 0,001) unterschieden sich signifikant zwischen den einzelnen Untersuchungszeitpunkten. Die einzelnen Zeitpunkte unterschieden sich ebenfalls signifikant voneinander (Wilcoxon-Test; U1 – U2: Z = –11,0; p < 0,001; U1 – U3: Z = –6,6; p < 0,001; U2 – U3: Z = –4,5; p < 0,001). Die höchsten Prävalenzraten der Depressivität werden präpartal erreicht. Während es am 2. postpartalen Tag zu einem Rückgang der Prävalenz kommt, ist 6 Monate postpartal ein erneuter Anstieg zu verzeichnen. Der präpartale Ausgangswert wird jedoch nicht erreicht. Diskussion: Die von uns ermittelten EPDS-Werte postpartal liegen im Rahmen vergleichbarer Studien. Die erhöhten und prädiktiv bedeutsamen EPDS-Werte präpartal sind ein Hinweis auf die Notwendigkeit und Möglichkeit von Diagnostik und Prävention bereits in der Schwangerschaft.
Abstract
Introduction: Postpartal affective disorders are with a prevalence between 8 % and 15 % highly frequent maternal diseases after childbirth. An undetected and untreated postpartum depression causes a wide range of negative consequences such as risk of a chronic manifestation of a major depression, social retreat, limitations in the bonding behavior, and behavioral disorders of the child. Therefore, an early detection of pregnant women at risk is warranted. Methods: Within a prospective study (FRAMES: Franconian Maternal Health Evaluation Studies), 1,100 pregnant women were interviewed with standardized questionnaires at three points of time: Prepartal (U1): from the 30th week of pregnancy onwards, 48 – 72 hours (U2) postpartum (pp) und 6 – 8 months pp (U3). 554 women were included in the substudy Blue FRAMES, where an additional telephone interview at the 10th day pp was conducted with a focus on symptoms relating to Baby Blues such as mood instability, irritability and concentration deficits. The Edinburgh Postnatal Depression Scale (EPDS) and the Hamilton Rating Scale For Depression (HAMD) were used for quantification of depressivity at each point of time. Results: EPDS values differed significantly (Friedman Test; χ2 = 110.8; df = 2, p < 0,001) between the different examination points (Wilcoxon Test; U1 – U2: Z = –11.0; p < 0.001; U1 – U3: Z = –6.6; p < 0.001; U2 – U3: Z = –4,5; p < 0,001). Regarding EPDS values, higher values were observed prepartum (U1). After a decrease after two to three days postpartum (U2), values increased again. However, EPDS values six months postpartum (U3) were still lower than prepartum (U1). Discussion: The observed EPDS values postpartum are comparable to results of other studies. The higher EPDS values prepartum have a good predictive value. There is a great need and possibility for improved prevention of postpartal disorders, when appropriately addressed in the prepartum period.
Schlüsselwörter
postpartale Depression - Schwangerschaft - EPDS - Epidemiologie
Key words
postpartal depression - pregnancy - EPDS - epidemiology
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Dr. Tamme Goecke
Klinik für Frauenheilkunde und Geburtshilfe, Perinatalzentrum Franken, Universitätsklinik Erlangen
Universitätsstraße 21 – 23
91054 Erlangen
Email: tamme.goecke@uk-erlangen.de