工作期间视屏时间和非工作期间视屏时间与产妇产后抑郁焦虑症状及共患关联研究

Associations of work-related and non-work-related screen time with postpartum depressive and anxiety symptoms and their comorbidity among postpartum women

摘要

目的 探讨产妇工作期间视屏时间、非工作期间视屏时间与产后抑郁症状、焦虑症状及共患的关联。方法 本研究为多中心横断面调查,于2023年11月至2024年6月,采用方便抽样方法,收集安徽省淮北市、界首市、马鞍山市、黄山市4个地区产妇的工作期间视屏时间、非工作期间视屏时间、睡眠质量、抑郁症状、焦虑症状等数据。产妇的抑郁症状通过爱丁堡产后抑郁量表(EPDS)评估,产妇的焦虑症状通过广泛性焦虑量表(GAD-7)评估。采用多因素Logistic回归模型分析视屏时间与产后抑郁症状、焦虑症状及共患的关联。结果 共获得3 094份产妇数据,其中产后42天、3个月、6个月及12个月产妇的抑郁症状检出率分别为22.3%、20.3%、21.2%、15.8%,焦虑症状检出率分别为28.6%、29.2%、26.1%、19.6%,两者共患检出率分别为16.3%、16.2%、15.8%、11.4%。控制年龄、收入、调查时点等因素后,与工作期间视屏时间小于2小时相比,工作期间视屏时间为2~6小时是产后抑郁症状、抑郁焦虑症状共患的危险因素(OR值分别为1.42、1.34,P<0.05),超过6小时是产后抑郁症状、焦虑症状、抑郁焦虑症状共患的危险因素(OR值分别为1.60、1.61、1.87,P<0.05);进一步控制睡眠质量后,结果趋势相同(OR值介于1.29~1.58之间,P<0.05)。控制年龄、收入、调查时点等因素后,与非工作期间视屏时间小于2小时相比,非工作期间视屏时间2~6小时、超过6小时均是产后抑郁症状、焦虑症状、抑郁焦虑症状共患的危险因素(OR值分别为1.27、1.33、1.38、1.63、1.75、1.98,P<0.05);进一步控制睡眠质量后,非工作期间视屏时间超过6小时仍是产后焦虑症状、抑郁焦虑症状共患的危险因素(OR值分别为1.41、1.52,P<0.05)。结论 工作期间视屏时间和非工作期间视屏时间对产后抑郁、焦虑症状及二者共患的发生风险影响较大,合理控制视屏使用时间可成为减少产后抑郁、焦虑症状的潜在干预目标。

Abstract

Objective This study aims to examine the associations between screen time during working hours and screen time during non-working hours among postpartum women and symptoms of postpartum depression,postpartum anxiety,as well as their comorbidity presentation. Methods A multi-center cross-sectional investigation was implemented over the period November 2023 to June 2024.Participants,consisting of postpartum women residing in four geographical sites across Anhui Province (Huaibei,Jieshou,Ma'anshan,Huangshan),were enrolled through a convenience sampling strategy.Questionnaires were administered to gather data covering screen use duration during working hours and screen time during non-working hours,sleep quality,depressive manifestations,and anxious symptoms.The Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 (GAD-7) served as standardized tools for the assessment of postpartum depressive and anxiety symptoms,respectively.Multivariate logistic regression models were used to quantify associations between screen time exposure and three outcomes:sole postpartum depression,sole anxiety symptoms,and comorbidity depression-anxiety. Results A total of 3 094 valid questionnaires were collected.The prevalence of depressive symptoms of depressive symptoms at 42 days,3,6,and 12 months postpartum were 22.3%,20.3%,21.2%,and 15.8%;anxiety symptoms detection rates were 28.6%,29.2%,26.1%,and 19.6%,while comorbidity rates of both symptoms were 16.3%,16.2%,15.8%,and 11.4%.After adjusting for age,income,and survey time,2-6 hours of work screen time was linked to higher odds of postpartum depression and comorbidity depression-anxiety (OR=1.42 and 1.34,respectively,P<0.05),and >6 hours of work screen time increased risks for all three emotional outcomes (OR=1.60,1.61 and 1.87,respectively,P<0.05).These associations held after additional adjustment for sleep quality (adjusted ORs:1.29-1.58,P<0.05).For non-work screen exposure,both 2-6 hours and >6 hours use were risk factors for depression,anxiety,and their comorbidity (OR=1.27,1.33,1.38,1.63,1.75 and 1.98,all P<0.05) in the initial adjusted model.When sleep quality was further controlled,only over 6 hours of off-work screen time remained an independent risk factor for anxiety and comorbid symptoms (OR=1.41 and 1.52,respectively,P<0.05). Conclusion Screen time during working hours and screen time during non-working hours are associated with increased risks of postpartum depressive symptoms,anxiety symptoms,and their comorbidit.Appropriate limitation of screen use is a potential intervention to reduce postpartum depressive and anxiety symptoms.

关键词

产后抑郁 / 焦虑 / 共患 / 视屏时间

Key words

postpartum depression / anxiety / comorbidity / screen time

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基金资助

国家自然科学基金(81761128034)