BACKGROUND Depressive symptoms are prevalent during pregnancy and the postpartum period and affect risk for smoking relapse. Whether and how depression affects response to postpartum interventions designed to sustain smoking abstinence is unknown. PURPOSE We examined end-of-pregnancy depressive symptoms as a moderator of response to two postpartum-adapted smoking relapse prevention interventions. METHODS Women (N = 300) who quit smoking during pregnancy were randomized to receive either a postpartum intervention focused on psychosocial factors linked to postpartum smoking (Strategies to Avoid Returning to Smoking [STARTS]) or an attention-controlled comparison intervention (SUPPORT). Women completed the Edinburgh Postnatal Depression Scale at the end of pregnancy. Smoking status was biochemically assessed at the end of pregnancy and at 12, 24, and 52 weeks postpartum. RESULTS End-of-pregnancy depressive symptoms moderated response to postpartum smoking relapse prevention interventions (χ2 = 10.18, p = .001). After controlling for variables previously linked to postpartum smoking relapse, women with clinically significant end-of-pregnancy depressive symptoms (20%) were more likely to sustain abstinence through 52 weeks postpartum if they received STARTS. In contrast, women with few end-of-pregnancy depressive symptoms were more likely to sustain abstinence through 52 weeks postpartum if they received SUPPORT. Changes in the psychosocial factors addressed in the STARTS intervention did not mediate this moderation effect. CONCLUSION Assessment of end-of-pregnancy depressive symptoms may help determine success following postpartum smoking relapse prevention interventions. Women with elevated end-of-pregnancy depressive symptoms benefited from postpartum relapse prevention intervention tailored to their psychosocial needs, while those with few symptoms were more successful in postpartum intervention that used standard behavioral components. CLINICAL TRIAL REGISTRATION NCT00757068.

中文翻译：

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在妊娠末期评估的抑郁症状预测对产后吸烟复发预防干预的不同反应。

背景 抑郁症状在怀孕和产后普遍存在，并影响吸烟复发的风险。抑郁症是否以及如何影响对旨在维持戒烟的产后干预措施的反应尚不清楚。目的 我们检查了妊娠末期抑郁症状作为对两种产后适应吸烟复发预防干预措施反应的调节因子。方法 怀孕期间戒烟的女性（N = 300）随机接受产后干预，重点关注与产后吸烟相关的心理社会因素（避免重返吸烟的策略 [STARTS]）或注意力控制的比较干预（支持）。妇女在怀孕结束时完成了爱丁堡产后抑郁量表。吸烟状况在妊娠末期和 12、24、和产后 52 周。结果 妊娠末期抑郁症状减轻了对产后吸烟复发预防干预措施的反应（χ2 = 10.18，p = .001）。在控制了先前与产后吸烟复发相关的变量后，如果接受 STARTS，有临床上显着的妊娠末期抑郁症状的女性 (20%) 更有可能在产后 52 周内保持禁欲。相比之下，如果获得 SUPPORT 支持，几乎没有妊娠末期抑郁症状的女性更有可能在产后 52 周内保持禁欲。STARTS 干预中涉及的社会心理因素的变化并未调节这种调节效应。结论 对妊娠末期抑郁症状的评估可能有助于确定产后吸烟复发预防干预措施是否成功。妊娠末期抑郁症状升高的女性受益于针对其心理社会需求量身定制的产后复发预防干预，而症状较少的女性在使用标准行为成分的产后干预中更为成功。临床试验注册 NCT00757068。