孕中晚期抑郁孕妇的功能近红外光谱成像特征及其与抑郁的关系

Functional near-infrared spectroscopic imaging characteristics of depressed pregnant women in mid-to-late pregnancy and its relationship with depression

中文关键词:  孕产妇  抑郁  功能近红外光谱成像  临床特征

英文关键词:Pregnant and postpartum women  Depression  Functional near-infrared spectroscopy  Clinical characteristics

中文摘要:

      背景 孕中晚期抑郁对孕妇及其后代具有显著的负性影响。既往研究表明，孕中晚期抑郁孕妇额叶激活程度较低，但激活时相及其对抑郁症状的影响有待进一步研究。目的 分析孕中晚期抑郁孕妇的功能近红外光谱成像（fNIRS）特征，为辅助临床孕中晚期孕妇的抑郁筛查提供参考。方法 纳入2023年9月—2024年7月在绵阳市第三人民医院产科产检的、爱丁堡产后抑郁量表（EPDS）评分≥11分的40名孕中晚期孕妇为研究组，同期招募与研究组年龄、家族史、既往史相匹配的40名EPDS评分<11分的孕中晚期孕妇为对照组。采用自编问卷收集孕妇的基本信息。采用fNIRS技术检测孕中晚期孕妇在语言流畅性任务（VFT）期间前额叶及颞叶的积分值和重心值。采用Spearman相关分析考查孕中晚期抑郁孕妇EPDS评分与fNIRS指标及基本资料的相关性。采用多元线性回归分析考查孕中晚期孕妇抑郁症状的影响因素。结果 研究组和对照组的受教育程度和体质量指数（BMI）比较，差异均有统计学意义（χ²/t=4.528、2.292，P均<0.05）。研究组前额叶积分值低于对照组，前额叶重心值高于对照组，差异均有统计学意义（t=-7.601、5.641，P均<0.05）。孕中晚期抑郁孕妇EPDS评分与前额叶积分值呈负相关（r=-0.680，P<0.01），与前额叶重心值和BMI均呈正相关（r=0.737、0.604，P均<0.01）。多元线性回归分析显示，年龄（β=-0.214，P<0.01）、BMI（β=0.340，P<0.01）、前额叶积分值（β=-0.351，P<0.01）以及前额叶重心值（β=0.347，P<0.01）是孕中晚期孕妇抑郁症状的影响因素。结论 孕中晚期抑郁孕妇较非抑郁孕妇的前额叶激活程度更低，激活时相延迟。年龄、前额叶积分值、前额叶重心值以及BMI可能是孕中晚期孕妇抑郁症状的影响因素。

英文摘要:

      Background Depression in mid-to-late pregnancy has significant negative effects on pregnant women and their offspring. Previous studies have shown that pregnant women with depression in mid-to-late pregnancy exhibit lower frontal lobe activation levels， but the activation phase and its impact on depression require further investigation.Objective To analyze the functional near-infrared spectroscopy （fNIRS） features of depressed pregnant women in mid-to-late pregnancy， and to provide references for assisting in the clinical screening of depression in them.Methods A total of 40 pregnant women in mid to late pregnancy with Edinburgh Postnatal Depression Scale （EPDS） score above 11 who underwent prenatal examination at the department of obstetrics of the Third Hospital of Mianyang from September 2023 to July 2024 were included as the study group. During the same period， 40 pregnant women in mid-to-late pregnancy with EPDS score below 11 who were matched with the age， family history， and past history of the study group were recruited as the control group. A self-designed questionnaire was used to collect basic information of the pregnant women. The fNIRS technique was used to measure the prefrontal and temporal lobe integral values and center of gravity values during the verbal fluency task （VFT） pregnant women in mid-to-late pregnancy. Spearman correlation analysis was conducted to examine the correlation between EPDS scores and fNIRS imaging features， as well as demographic characteristics， in mid-to-late pregnant women with depression. Multiple linear regression was used to analyze the influencing factors of depression symptoms in this population.Results Statistically significant differences were observed between the study group and the control group in terms of educational level and body mass index （BMI） （χ²/t=4.528， 2.292， P<0.05）. The study group demonstrated a lower prefrontal integral value and a higher prefrontal center of gravity value compared with the control group （t=-7.601， 5.641， P<0.05）. EPDS scores of depressed pregnant women in mid-to-late pregnancy were negatively correlated with prefrontal lobe integral value （r=-0.680， P<0.01）， while positively correlated with prefrontal lobe center of gravity value and BMI （r=0.737， 0.604， P<0.01）. Multiple linear regression analysis showed that age （β=-0.214， P<0.01）， BMI （β=0.340， P<0.01）， prefrontal integral value （β=-0.351， P<0.01）， and prefrontal center of gravity value （β=0.347， P<0.01） were influencing factors of depressive symptoms in pregnant women in mid-to-late pregnancy.Conclusion The prefrontal lobe activation degree of depressed pregnant women in mid-to-late pregnancy is lower than that of non-depressed pregnant women， and the activation phase is delayed. Age， prefrontal lobe integral value， prefrontal center of gravity value and BMI may be the influencing factors of depressive symptoms in pregnant women in the middle and late pregnancy.