北京市海淀区流动人口产后妇女意外妊娠及影响因素

目的：了解海淀区流动人口产后妇女意外妊娠情况及其影响因素。方法方便抽样选取海淀区8所社区卫生服务中心,利用调查问卷对1124例流动人口产后1～1．5年的妇女意外妊娠情况进行回顾性调查。结果产后第1年意外妊娠发生率为4．6％,经多因素分析：丈夫文化程度（OR＝0．427）、纯母乳喂养时间（相比3个月内,4～6个月：OR＝0．425;≥7个月：OR＝0．450）、人工流产或药物流产次数（相比0次,1次：OR＝9．159;≥2次：OR＝6．402）、月经恢复时间（相比4个月以内,5～8个月：OR＝0．600;≥9个月：OR＝0．267）、丈夫对避孕的态度（OR＝0．331）是产后1年内发生意外妊娠的影响因素（均 P＜0．05）。结论加强避孕节育知识的宣传,纠正人们在避孕节育思想中的错误传统观念,积极推进男性参与避孕节育的宣传活动,同时要加强宣传男性在避孕节育方面的责任感,尤其是对低学历男性。     

围绝经期女性抑郁症状及其影响因素的探讨

目的调查广州市社区围绝经期女性抑郁症状发生情况,并探讨其影响因素,为制定针对性的社区干预策略和措施提供依据。方法采用随机与整群抽样相结合的方法,以广州某城区和市郊两社区为流调现场,抽取40～55岁721例围绝经期女性为研究对象,其中市区368人,郊区各353人,采用自评抑郁量表（SDS）、生活事件量表（LES）、社会支持评定量表（SSRS）、应对方式问卷（CSQ）和一般社会人口学调查表（SDQ）进行调查和评价,运用多元逐步回归分析的方法,探讨影响其抑郁水平的保护因素和危险因素。结果抑郁症状发生率为8．04％,46～50岁组发生率（12．35％）显著高于40～45岁组（6．22％）和51～55岁组（5．49％,χ2=9．2552,P〈0．01）;城市社区抑郁症状发生率（10．33％）显著高于郊区社区（5．67％,χ2=5．2902,P〈0．05）;负性事件刺激量和自责是抑郁症状发生的危险因素,对支持利用度则是其保护因素;生活事件、社会支持和应对方式均与自评抑郁量表评分存在正性或负性显著性相关,各因子间也存在一些显著性相关。结论围绝经期抑郁的发生受多因素影响,应采取多层次和有针对性的干预措施。     

Prevalence and predictors of depressive symptoms among rural older Australians and Americans

OBJECTIVE: To examine the predictors of depressive symptoms among older married rural Australian and American men and women, using comparable measures from two separate studies. DESIGN: Postal survey for Australians; telephone interviews for Americans. SETTING: Rural Australia (six states and two territories) and America (Virginia). PARTICIPANTS: Older married rural men and women, aged 65 years and over, in Australia (n = 216) and America (n = 156). MAIN OUTCOME MEASURES: Whether predictors of depressive symptoms, specifically demographic factors, health, pain, functional limitations and social networks, differed according to nationality or sex. RESULTS: Approximately one-third of older rural Australian (37%) and Americans (28%) reported recently experiencing depressive symptoms. For Australian men and women, pain was the strongest predictor of depressive symptoms. For American women, dissatisfaction with social support predicted depressive symptoms, whereas no variable predicted depressive symptoms in American men. CONCLUSIONS: In the context of a globally ageing population, the fact that nearly one in three older rural people on two continents described themselves as recently feeling depressed is a troubling finding of considerable importance to both practitioners and policy-makers. The findings raise questions about the cultural acceptance, definition and manifestations of symptoms of depression in rural communities, as well as the role of different public health and support systems in the two countries.     

Identifying risk and protective factors related to depressive symptoms among Northern Plains American Indian women cancer survivors

Cancer is the leading cause of death among American Indian and Alaska Native (AIAN) women, and depressive symptoms have been linked to higher mortality, but research on depressive symptoms among AIAN cancer patients has been scant. The purpose of this exploratory study was, using the Framework of Historical Oppression, Resilience, and Transcendence, to examine risk and protective factors related to depressive symptoms in American Indian (AI) women cancer survivors. We examined the relationships of adverse childhood experiences (ACE), perceived health status, resilience, and social support with depressive symptoms in Northern Plains AI women cancer survivors. We used a cross-sectional design with purposive sampling of 73 female cancer survivors (aged 18 years or older) between June 2014 and February 2015. Hierarchical multiple regression was used to test three sets of variables in relation to depressive symptoms: (1) sociodemographics, (2) risk factors (ACE and perceived health), and (3) protective factors (psychological resilience and social support). Approximately 47 percent of participants had probable depressive symptoms. Depressive symptoms were inversely associated with perceived health, psychological resilience, and social support. These results support bolstering existing social support among AI cancer patients and survivors as well as prevention and intervention efforts that strengthen resilience.     

Sexual desire among Mexican-American older women: a qualitative study

Although researchers have related sexual desire in older women to quality-of-life variables such as overall physical health, well-being, and life satisfaction, little is known about the socio-cultural mechanisms that shape sexual desire in minority ethnic older women. We investigated this sexual variable among Mexican-American older women in a qualitative fashion. Data were collected from 25 community-dwelling women of Mexican descent (aged 59–89 years) using a semi-structured interview protocol and a grounded theory approach. We inquired about dimensions of sexual desire including sexual fantasies and the desire to engage in sexual activity within the context of several socio-cultural and health-related factors. Using content analysis, we were able to identify key themes differentiating among respondents’ levels of sexual desire and fantasies. These included the availability of a suitable partner, cultural and religious norms pertinent to women's sexuality, stigma related to sexuality in older age, and health status. Traditional socio-cultural restrictions coupled with unmarried status and physical health problems emerged as critical issues associated with limited or no sexual fantasies and desire in our sample. Many respondents indicated that their sexual needs were unmet.     

Perinatal weight and risk of prenatal and postpartum depressive symptoms

PurposePrepregnancy obesity and weight changes accompanying pregnancy (gestational weight gain and postpartum weight retention) may be associated with risk of maternal depressive symptoms during pregnancy and in the postpartum. The few studies that have examined these relationships report conflicting findings.MethodsWe studied pregnant (n = 2112) and postpartum (n = 1686) women enrolled in Project Viva. We used self-reported prepregnancy and postpartum weight and measured prenatal weight to calculate prepregnancy body mass index (BMI), gestational weight gain (GWG), and postpartum weight retention at 6 months after birth. We assessed elevated depressive symptoms (EDS) with the Edinburgh Postnatal Depression Scale (≥13 on 0–30 scale) at midpregnancy and 6 months postpartum. We used logistic regression to estimate the odds of prenatal and postpartum EDS in relation to prepregnancy BMI, GWG, and postpartum weight retention.ResultsA total of 214 (10%) participants experienced prenatal EDS and 151 (9%) postpartum EDS. Neither prepregnancy BMI nor GWG was associated with prenatal EDS. Prepregnancy obesity (BMI ≥ 30 kg per m²) was associated with higher odds of postpartum EDS (odds ratio = 1.69, 95% confidence interval, 1.01–2.83) compared to normal prepregnancy weight in a model adjusted for age, race/ethnicity, nativity, education, marital status, household income, parity, pregnancy intention, and smoking.ConclusionsPrepregnancy obesity is associated with elevated depressive symptoms in the postpartum period. Given the current obesity epidemic in the US and the consequences of perinatal depression, additional prevention and screening efforts in this population may be warranted.     

中学生社会经济状况与抑郁症状关系

目的了解江苏省南京市社会经济状况(SES)与中学生抑郁症状的关系。方法采取整群抽样方法,采用父母职业类型、父母受教育程度、家庭收入3个变量衡量父母SES水平,于2009年及2010年采用抑郁自评量表(SDS)对南京地区5个学校53个班级2 202名在校中学生进行2次调查。结果实际调查2 160名中学生,1年后随访调查2 118名中学生;随访前(44.0%)后(46.0%)比较,抑郁症状检出率差异无统计学意义;中、重度抑郁症状比例明显提高,差异有统计学意义(χ2=11.447,P=0.010);经多因素调整,低水平SES的中学生1年后随访存在抑郁症状的风险明显高于高水平SES中学生,即SES与抑郁症状呈负相关关系;调整人群归因危险度百分比(PARc%)为家庭平均月收入最高。结论社会经济状况与中学生抑郁症状存在负相关关系;应引起卫生、教育工作者关注。     

Associations among postpartum depression, eating disorders, and perfectionism in a population-based sample of adult women

OBJECTIVE: The current study investigated associations among eating disorders, depressive symptoms during pregnancy and postpartum, and perfectionism in a population-based sample of women. METHOD: Females who reported > or = 1 pregnancy (N = 1,119) completed questionnaires assessing perfectionism, eating disorder symptomatology, and depression during pregnancy and postpartum. Information regarding participants' history of major depressive disorder (MDD) was also available from structured psychiatric interviews completed during a previous wave of data collection. RESULTS: Depressive symptoms during pregnancy and postpartum were high among women with a history of eating disorders. Both binge eating disorder (BED) and bulimia nervosa (BN) were positively associated with symptoms of postpartum depression (PPD), even when lifetime MDD was controlled. However, logistic regression indicated that women with a history of BN and BED are at particular risk of developing PPD symptomatology. Linear regression analyses conducted with the subset of the sample who endorsed a PPD screening item suggested that the severity of PPD symptomatology may be attributable to Concern Over Mistakes, a specific aspect of perfectionism. CONCLUSION: These results highlight the importance of assessing specific features of perfectionism. In addition, they suggest that women with BN, BED, or high Concern over Mistakes may be at particular risk of developing PPD symptoms, and could benefit from prenatal screening.     

Declining HIV prevalence among women attending antenatal care in Pune, India

A declining prevalence of HIV among young women has been reported by the public sector implementing prevention of mother-to-child transmission (PMTCT) programmes, sentinel surveillance sites and research institutions in India. However, there are no reports evaluating such trends from the private healthcare sector. This study is a retrospective analysis of data collected by PRAYAS as a part of the PMTCT programme at Sane Guruji Hospital (SGH), a secondary care hospital in Pune, India. Women attending the antenatal clinic at SGH were screened for HIV following a group counselling session, with an option to opt out. Between January 2003 and March 2008, the overall HIV prevalence was 111/17 578 (0.6%, 95% CI 0.5-0.7%). The HIV prevalence among antenatal women was 1.1% in 2003 and 0.2% in 2008 (i.e. 82% decline in HIV prevalence over the 5-year period) and the odds ratio (OR) of HIV prevalence declined by 0.24 per year from 2003 to March 2008 (OR = 0.76, 95% CI 0.69-0.87; P < 0.001). The risk of having HIV infection was significantly higher in women aged ≥24 years and those who were uneducated. To our knowledge, this is the first report from any private sector health system in India documenting a declining HIV prevalence among antenatal women. Characterising the risk profile of this small percentage of at-risk women will help in planning prevention strategies.     

初产妇产后抑郁的社区干预措施及效果

目的:探讨社区干预对初产妇产后抑郁的效果。方法:采用实验研究方法于2006～2007年在社区抽取正常分娩、母婴健康的初产妇302例,随机分为两组,干预组接受常规保健+社区干预(包括上门访视及讲座),对照组则只接受常规保健服务。于干预前后分别测试两组的产后抑郁情况。结果:干预组与对照组产后第3个月、第6个月的抑郁得分差异有统计学意义,干预组与对照组产后第3个月的产后抑郁发生率差异有统计学意义。结论:社区干预可有效减低初产妇产后第3个月产后抑郁的发生率。     

北京市朝阳区825例流动孕产妇产前检查现状及影响因素分析

目的了解北京市朝阳区流动孕产妇产前检查的基本现状及相关影响因素,为制定流动孕产妇孕期保健服务的相关卫生政策提供参考依据。方法采用分层整群抽样,选取朝阳区流动人口相对密集的7个街道/乡镇随机抽取825例流动产妇(对象为1岁以下儿童母亲)进行回顾性问卷调查。结果流动产妇中认为妊娠期间需要进行产前检查的为93.0%,而实际孕期建立《母子健康档案》的只占35.5%;21.2%的流动产妇在私人诊所做过产前检查。在对医院服务的综合评价中最不满意的是就诊等候时间。结论私人诊所为流动孕产妇提供廉价和不健全的产前检查服务这一因素不容忽视。通过取缔非法行医诊所,改善医疗管理体制,制定合理的收费标准,以满足不同层次流动孕产妇的孕期保健需求;加大宣传力度是增强孕产妇主动寻求孕期保健服务的有效手段。     

Prevalence of anxiety and depressive symptoms among obese pregnant and postpartum women: an intervention study

Background  

Although studies have shown an association between anxiety and depression and obesity, psychological health among obese women during and after pregnancy has not been carefully studied. The aim of this study was to investigate psychological well-being using symptoms of depression and/or anxiety among obese pregnant women attending a weight gain restriction program and to then compare this group with a control group receiving traditional antenatal care.     

二胎孕妇产后抑郁现状及相关因素分析

目的 了解二胎孕妇产后抑郁现状并探讨其相关影响因素.方法 自2016年3月1日至2017年2月1日,采用随机数字表的方法,随机抽取5家乌鲁木齐市的三级医院,将所有符合纳入标准的住院分娩的二胎孕妇作为研究对象.采用问卷调查的方法,对分娩后2~7天的二胎孕妇发放一般情况调查表、爱丁堡产后抑郁量表、焦虑自评量表、抑郁自评量表和社会支持评定量表以测量二胎孕妇产后抑郁状况,并探讨相关影响因素.结果 共发放861份问卷,有效问卷824份,问卷有效率为95.70%.参加调查的二胎孕妇产后抑郁患病率为34.71%,孕期增重、民族、职业、家庭月收入、婆媳关系、是否陪伴分娩、有无妊娠合并疾病、新生儿性别满意度、是否早接触早吸吮、产前焦虑状况、产前抑郁状况、主观支持、客观支持、支持利用度均是二胎孕妇产后抑郁的影响因素,差异均有统计学意义(χ2/t值分别为16.766、11.106、19.139、6.066、10.151、4.733、7.684、6.924、9.234、39.166、21.856、8.798、12.237、10.113,均P<0.05).多因素Logistic回归分析结果显示,孕期增重(OR:1.803,95%CI:1.075~3.837)、无职业(OR:2.357,95%CI:1.384~4.253)、产前焦虑(OR:9.883,95%CI:6.154~8.231)和产前抑郁(OR:8.146,95%CI:5.332~7.164)这4个因素是二胎孕妇产后抑郁的危险因素;婆媳关系好(OR:0.893,95%CI:0.572~0.835)、对新生儿性别满意(OR:0.624,95%CI:0.321~0.546)、早接触早吸吮(OR:0.674,95%CI:0.441~0.683)、客观支持好(OR:0.412,95%CI:0.106~0.338)和对支持利用度好(OR:0.583,95%CI:0.239~0.482)这5个因素是二胎孕妇产后抑郁的保护因素.结论 二胎孕妇产后抑郁的患病率较高,且影响因素是多方面的,政府和相关组织及家庭成员应当关注二胎孕妇产后抑郁情况并且给予充分的社会支持,以改善二胎孕妇产后抑郁的患病现状.     

Intimate partner violence against adult women and its association with major depressive disorder, depressive symptoms and postpartum depression: a systematic review and meta-analysis

To date, few systematic reviews of observational studies have been conducted to comprehensively evaluate the co-morbidity of intimate partner violence (IPV) and specific depression outcomes in women. In this systematic review and meta-analysis, we summarize the extant literature and estimate the magnitude of the association between IPV and key depressive outcomes (elevated depressive symptoms, diagnosed major depressive disorder and postpartum depression). PubMed (January 1, 1980-December 31, 2010) searches of English-language observational studies were conducted. Most of the selected 37 studies had cross-sectional population-based designs, focused on elevated depressive symptoms and were conducted in the United States. Most studies suggested moderate or strong positive associations between IPV and depression. Our meta-analysis suggested two to three-fold increased risk of major depressive disorder and 1.5-2-fold increased risk of elevated depressive symptoms and postpartum depression among women exposed to intimate partner violence relative to non-exposed women. A sizable proportion (9%-28%) of major depressive disorder, elevated depressive symptoms, and postpartum depression can be attributed to lifetime exposure to IPV. In an effort to reduce the burden of depression, continued research is recommended for evaluating IPV preventive strategies.     

Passive smoking and postpartum depression among Chinese women: A prospective cohort study in Tianjin,China

Smoking has been associated with depression in the general population. Whether passive smoking is also associated with postpartum depression (PPD) is uncertain. From 2010 to 2012, we recruited 8,842 pregnant women in Tianjin, China. The mainland Chinese version of the Edinburgh Postnatal Depression Scale was used to evaluate postpartum depressive symptoms after birth, with a score of >9 defining PPD. Data were collected using specially designed questionnaires or data from the electronic database of Tianjin Maternal and Child Health Information System. Odds ratios (OR) and 95 percent confidence intervals (CI) were obtained for the association of smoking status with PPD using binary logistic regression. Passive smoke exposure rates before and during pregnancy were 40.9 percent and 52.1 percent, respectively. A total of 8.5% (n = 747) of participants had PPD. Compared with those not exposed, women passively exposed to smoke before and during pregnancy had higher odds of PPD (before pregnancy: OR: 1.24, 95 percent CI: 1.03–1.50; during pregnancy: OR: 1.43, 95 percent CI: 1.16–1.77) after adjustment for confounding factors. Passive smoking before and during pregnancy were associated with PPD in Chinese women. Reducing passive smoke exposure may reduce PPD in Chinese women; further longitudinal studies are warranted to replicate these findings.     

Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity

Ertel KA, Koenen KC, Rich‐Edwards JW, Gillman MW. Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity. Paediatric and Perinatal Epidemiology 2010; 24: 179–189. Antenatal depression is associated with small‐for‐gestational age, but few studies have examined associations with weight during childhood. Similarly, few studies address whether antenatal and postpartum depression differentially affect child weight. Among 838 mother–child dyads in Project Viva, a prospective cohort study, we examined relationships of antenatal and postpartum depression with child weight and adiposity. We assessed maternal depression at mid‐pregnancy and 6 months postpartum with the Edinburgh Postnatal Depression Scale (score ≥13 indicating probable depression). We assessed child outcomes at age 3 years: body mass index (BMI) z‐score, weight‐for‐height z‐score, sum of subscapular (SS) and triceps (TR) skinfold thickness (SS + TR) for overall adiposity, and SS : TR ratio for central adiposity. Sixty‐nine (8.2%) women experienced antenatal depression and 59 (7.0%) postpartum depression. Mean (SD) outcomes at age 3 were: BMI z‐score, 0.45 (1.01); SS + TR, 16.72 (4.03) mm; SS : TR, 0.64 (0.15). In multivariable models, antenatal depression was associated with lower child BMI z‐score (?0.24 [95% confidence interval: ?0.49, 0.00]), but higher SS : TR (0.05 [0.01, 0.09]). There was no evidence of a dose–response relationship between antenatal depression and these outcomes. Postpartum depression was associated with higher SS + TR (1.14 [0.11, 2.18]). In conclusion, whereas antenatal depression was associated with smaller size and central adiposity at age 3 years, postpartum depression was associated with higher overall adiposity.     

产褥期抑郁状态测评及其影响因素分析

目的：测评产褥期妇女抑郁状态并探讨相关影响因素，为卫生服务部门和妇幼卫生人员对产褥期妇女实施针对性的健康干预措施和有效保障该群体的心理健康提供理论依据。方法：采用SDS抑郁自评量表测量产褥期妇女的抑郁状态；以面对面访谈形式调查社会学、医学、家庭与心理学等方面的影响因素，并应用铲检验和多因素非条件Logistic回归进行分析。结果：产妇年龄每增加一个年龄组发生抑郁的概率要增大2.046倍；产妇各不同职业抑郁发生的概率均低于农民职业者；第一胎次的产妇发生抑郁的概率较大；夫妻感情较好或一般组产妇发生抑郁的概率比感情很好组产妇增加10．204倍；仅由丈夫及其家人照顾的产妇发抑郁生的概率是丈夫及双方家人照顾类型的2.166倍。家庭的年均收入越高且新生儿发育状况越好的产妇发生抑郁的概率越小。结论年龄、产妇职业、生产胎次、怀孕原因、夫妻感情和照顾类型6个变量对产妇抑郁的发生有影响作用；家庭年均收入与新生儿生长发育状况两个因素对产褥期抑郁的发生存在交互作用。