目的 观察益生菌对妊娠期糖尿病高危孕妇抑郁状况的影响,为妊娠期糖尿病高危孕妇抑郁状况改善提供新思路。方法 选择2020年6月至2021年6月就诊于南京市妇幼保健院具有妊娠期糖尿病高危因素的446例孕早期（15 w内）孕妇作为研究对象,随机分为益生菌组和安慰剂对照组各223例。从孕早期（15 w内）持续干预至孕晚期,每日服用益生菌或安慰剂一袋。通过基本情况调查问卷、抑郁自评量表采集入组时（15 w内）,孕中期（24~28 w）和孕晚期（34~36 w）妊娠期糖尿病高危孕妇的抑郁状况。结果 干预22 w后,益生菌组抑郁状况改善,和对照组相比有统计学差异（P<0.05）;与干预前相比,存在抑郁状况的妊娠期糖尿病高危孕妇在孕中期和孕晚期的抑郁状况均显著性下降（P<0.01）。结论 通过补充益生菌可以改善妊娠期糖尿病高危孕妇的抑郁状况。
Abstract
Objective To observe the effect of probiotics on the depression status in pregnant women at high risk of gestational diabetes mellitus (GDM), and to provide new ideas for improving the depression status. Methods A total of 446 pregnant women with high risk factors of GDM in Nanjing Maternal and Child Health Hospital from June 2020 to June 2021 were randomly divided into probiotics group (n=223) and placebo control group (n=223). From the first trimester (within 15 weeks) to the third trimester until delivery, one sachet of probiotics or placebo was administered per day. The depression status of the high-risk GDM groups with in the second trimester (24-28 weeks) and third trimester (34-36 weeks) at the time of enrollment (within 15 weeks) was evaluated through questionnaire and the depression self-rating scale. Results After 22 weeks of intervention, the depression status of the probiotic group was significantly improved compared with that of the control group (P<0.05). Compared with before the intervention, the depression status of the depressed pregnant women in the high risk GDM group decreased significantly after 12 and 22 weeks of intervention (P<0.01). Conclusion The depression status of the pregnant women at high risk of GDM can be improved by supplementing probiotics.
关键词
益生菌 /
抑郁 /
妊娠期糖尿病高危孕妇
Key words
probiotics /
depression /
high GDM risk pregnant women
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Herrman H, Patel V, Kieling C, et al. Time for united action on depression: a Lancet-World Psychiatric Association Commission[J].Lancet,2022,399: 957–1022.
[2] Lu J, Xu X, Huang Y, et al. Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2021, 8: 981–990.
[3] Bennett HA, Einarson A, Taddio A, et al. Prevalence of depression during pregnancy: systematic review[J]. Obstet Gynecol, 2004, 103: 698–709.
[4] Wilson CA, Newham J, Rankin J, et al. Is there an increased risk of perinatal mental disorder in women with gestational diabetes? A systematic review and meta-analysis[J]. Diabet Med, 2020, 37: 602–622.
[5] 周翔, 雷梦媛, 梁丹丹, 等. 妊娠期糖尿病与产后抑郁关系的Meta分析[J]. 现代预防医学, 2021, 48: 571–576.
[6] Hill C, Guarner F, Reid G, et al. Expert consensus document. The international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic[J]. Nat Rev Gastroenterol Hepatol, 2014, 11: 506–514.
[7] Miller AH, Raison CL.The role of inflammation in depression: from evolutionary imperative to modern treatment target[J]. Nat Rev Immunol, 2016, 16: 22–34.
[8] 李郦. 妊娠期糖尿病患者实施心理护理对血糖控制情况焦虑自评量表抑郁自评量表评分及产后转内科情况的影响[J].中国药物与临床, 2020, 20: 3689–3691.
[9] Slykerman RF, Hood F, Wickens K, et al. Effect of Lactobacillus rhamnosus HN001 in pregnancy on postpartum symptoms of depression and anxiety: a randomised double-blind placebo-controlled trial[J]. EBioMedicine, 2017, 24: 159–165.
[10] Shelly AB, Sean WD, Martina S, et al. Dissecting the contribution of host genetics and the microbiome in complex behaviors[J]. Cell, 2021,184: 1740–1756.
[11] Tian PJ, Zou RY, Wang LY, et al. Multi-probiotics ameliorate major depressive disorder and accompanying gastrointestinal syndromes via serotonergic system regulation[J]. J Adv Res, 2023, 45:117–125.
[12] Ng QX, Peters C, Ho CYX, et al. A meta-analysis of the use of probiotics to alleviate depressive symptoms[J]. J Affect Disord, 2018, 228: 13–19.
[13] Barthow C, Wickens K, Stanley T, et al. The Probiotics in Pregnancy Study (PiP Study): rationale and design of a double-blind randomised controlled trial to improve maternal health during pregnancy and prevent infant eczema and allergy[J]. BMC Pregnancy Childbirth, 2016, 16: 133.
[14] Hinkle SN, Buck Louis G, Rawal S, et al. A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period[J]. Diabetologia, 2016, 59: 2594–2602.
[15] Browne PD, Bolte AC, Besseling-van der Vaart I, et al. Probiotics as a treatment for prenatal maternal anxiety and depression: a double-blind randomized pilot trial[J]. Sci Rep, 2021, 11: 3051.
基金
江苏省研究生科研与实践创新项目（No.SJCX21_0088）
