| Summary: | 碩士 === 高雄醫學大學 === 護理學系碩士班 === 103 === Objectives: Preeclampsia/eclampsia has been linked to cognitive difficulties and neurocognitive dysfunction- both are predictors of depression. We hypothesized that preeclampsia /eclampsia patients might have a greater risk for developing major depression.
Method: Using the longitudinal National Health Insurance Research Database (LHID2010), we conducted a retrospective population-based cohort study to evaluate the incidence of preeclampsia(International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM code 642.4 and 642.5) and eclampsia (ICD-9-CM code 642.6 and 642.7) in adult major depressive patients and controls matched (1:4) by age. Kaplan-Meier analysis and Cox regression were conducted to compare differences in the development of major depression(ICD-9-CM code 296.2 and 296.3).
Results: We identified 1329 adults preeclampsia/eclampsia patients and 5316 controls. Our results showed that women with preeclampsia/eclampsia had high frequencies of first delivery(86%), once of occurrence(94%)(mean age 29.8 years), and surgical delivery(76%). Furthermore, we also showed that the occurrence of eclampsia>1 women (mean age 27.0 years) had 13% of major depression when compared to the occurrence of eclampsia=1 women (mean age 29.6 years; P=0.0476). The cumulative incidence of preeclampsia/eclampsia in major depressive patients was significantly higher than controls (log-rank test P=0.0174), specifically 7th year follow up. The incidence rate of preeclampsia/eclampsia(7.08 per 10000 person-years) in major depressive patients was significantly higher than controls(2.56 per 10000 person-years; incidence rate ratio (IRR)=2.76, P=0.0260). After adjusting for potential confounders, preeclampsia/eclampsia was an independent predictor for major depression (adjusted hazard ratio= 2.63, 95% confidence interval 1.01-6.85; P=0.0472). The attributable risk percent(AR%) of major depression explained by preeclampsia/eclampsia was 64%.
Conclusions: Women with preeclampsia/eclampsia are at increased risk of major depression independently compared with the general once pregnant women. In health administration policy and public health community care(nursing care and preventive medicine), this information could help identify individuals at risk for major depression and development long before the onset of clinical features of the disease.
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