产后抑郁症的发生率及其心理社会因素研究

目的调查产后抑郁症的发生率以及相关的心理社会因素.方法采用爱丁堡产后抑郁量表(Edinburgh PostnatalDepression Scale,EPDS)对427例产后4～6周妇女的抑郁状态进行调查,相关的心理社会因素用logistic回归模型分析.结果产后抑郁症的发生率为7.3%(31/427);产后缺乏社会支持、孕期抑郁情绪、过低或过高的家庭收入与产后抑郁症密切相关.结论心理社会因素对产后抑郁症发生的影响不容忽视.     

产后抑郁症的发生率及其心理社会因素研究

目的：调查产后抑郁症的发生率以及相关的心理社会因素。方法：采用爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale,EPDS)对427例产后4～6周妇女的抑郁状态进行调查，相关的心理社会因素用logistic回归模型分析。结果：产后抑郁症的发生率为7.3％(81／427)；产后缺乏社会支持、孕期抑郁情绪、过低或过高的家庭收入与产后抑郁症密切相关。结论：心理社会因素对产后抑郁症发生的影响不容忽视。     

慢性HBV感染产妇产后抑郁症发生率调查与原因分析

目的:探讨慢性HBV感染产妇产后抑郁症发病情况及其影响因素。方法:采用孕期调查表、焦虑抑郁评定量表、爱丁堡产后抑郁量表和产后调查表分别于孕28～36周和产后4～6周对孕产妇进行调查。结果:慢性HBV感染产妇产后抑郁发生率为28.20%,其中顺产者产后抑郁症的发生率为26.11%(82/314),剖宫产及手术助产的产妇产后抑郁症的发生率为31.19%(68/218),两者差异无统计学意义(χ2=2.89,P>0.05)。这表明分娩方式与产妇产后抑郁发生无相关性。单因素分析结果表明,母婴阻断失败、母乳喂养中断、妊娠期焦虑、妊娠期抑郁、相关知识缺乏、经济收入低等6项为危险因素,家庭关系融洽、母婴阻断依从性良好2项为保护因素;多因素分析结果表明,母婴阻断失败、母乳喂养中断、妊娠期抑郁等3项为危险因素,家庭关系融洽、母婴阻断依从性良好2项为保护因素。结论:慢性HBV感染产妇产后抑郁症发生率高,母婴阻断效果及围产期心理社会因素与产后抑郁症发生密切相关。     

产后抑郁症的心理社会因素调查研究

目的:研究产后抑郁症的发生率及其相关的心理社会因素。方法:选取2008～2009年在该院分娩的无产前抑郁症的120例初产妇,采用汉密尔顿抑郁量表(HAMD-17)、爱丁堡产后抑郁量表(EPDS)、自编心理社会因素调查表对产妇产后的抑郁情况进行分析。结果:产后抑郁发生率为18.33%,而年龄、家庭经济状况、分娩方式、新生儿性别、居住条件、夫妻关系、婆媳关系、产后睡眠情况等的不同对产后抑郁症的影响有明显统计学差异(P<0.05或P<0.01)。结论:心理社会因素对产后抑郁的影响不容忽视。临床上,我们应减少相关危险因素的发生,对已经存在的危险因素及时进行干预,从而减少产后抑郁的发生。     

产后抑郁症的危险因素与预防

目的:探讨产后抑郁症(PPD)的发生情况及危险因素。方法:应用爱丁堡产后抑郁量表(EPDS)、肖水源社会支持评定量表(SSRS)、产妇一般情况和产科情况调查表对在本院分娩的1325例产妇于产后3～7天进行调查。EPDS总分≥13分诊断为产后抑郁症。对所得数据进行单因素分析和多因素分析,筛选出产后抑郁症的危险因素。结果:产后抑郁症的发生率是13.96%(185/1325例)。单因素分析有23种因素与产后抑郁症明显相关;多因素非条件Logistic回归分析有7种因素进入回归模型,分别是产妇职业、居住方式、家庭经济收入、分娩前心理准备、分娩后睡眠状况、新生儿健康状况和客观社会支持,这些因素是产后抑郁症的主要危险因素。结论:产后抑郁症发生率高,其发生与心理、社会、新生儿因素密切相关,应针对各种危险因素积极预防。     

孕产妇情绪评估调查与产后抑郁症预防

目的:探讨产后抑郁症的发生率及其相关危险因素,为产后抑郁症的预防提供科学依据。方法:对住院分娩的268例产妇进行产前及产后基本情况调查,应用医院焦虑抑郁量表(HAD)评估孕妇孕期情绪状况,应用爱丁堡产后抑郁量表(EPDS)对产妇进行随访调查至产后3～7天。结果:产后抑郁症的发生率为17.91%,分析显示夫妻双方的文化程度、家庭收入、孕产妇是否在职、围产期夫妻关系及家庭关系、新生儿的健康状况、婴儿的照顾方式等10个因素与产后抑郁症发生相关(P<0.05)。结论:产后抑郁症发病率高,早期筛查其危险因素及时采取积极的干预措施十分重要,应受到广大医务工作者的足够重视。     

产后抑郁症发生率及相关因素分析

目的:了解深圳市产后抑郁症的发病情况,探讨产后抑郁症的相关因素及早期干预措施。方法:用随机数字表随机抽取深圳市100家社康中心为调查点,采用流调用抑郁量表(CES-D)和自编一般健康问卷对2007年3～10月在深圳市分娩的2 216例产妇进行流行病学调查,采用χ2检验、Logistic回归分析方法分析产后抑郁发生的影响因素。结果:产后抑郁发生率8.12%。产后抑郁症的主要危险因素有:配偶饮酒、职业类型及文化程度、对胎儿性别期望,产妇对分娩过程恐惧、产后形体改变、抚养孩子信心不足,差异具有显著统计学意义(P<0.01)。孕期接受保健指导、心理调适、保健人员对产后家庭进行健康教育和社会支持是保护因素。结论:产后抑郁症应受到广大医务工作者的足够重视,加强产前保健,拓展产后家访内容,开展产后抑郁症早期筛查与监测,早期发现危险因素,采取积极主动的心理辅导,是维护和促进产妇心理健康、提供心理卫生"三级预防"、减少孕产妇死亡重要措施之一。     

958例产妇产后抑郁症研究

目的:探讨产后抑郁症的发生情况及危险因素,为产后抑郁症的预防提供参考。方法:应用爱丁堡产后抑郁量表和产妇、新生儿一般情况、产科情况调查表对在迁西县医院分娩的958例产妇在产后3～7天内进行调查。爱丁堡产后抑郁量表总分≥13分诊断为产后抑郁症。结果:产后抑郁症的发生率为14.72%(141/958),与产妇的文化程度、固定收入、夫妻感情、社会支持、睡眠、新生儿健康状况显著相关。结论:产后抑郁症发病率高,应受到重视。早期干预,预防危险因素十分重要。     

产后抑郁症与血浆中皮质醇及雌孕激素水平的相关性研究

目的探讨产后抑郁症与血浆皮质醇、雌二醇及孕酮之间的关系。方法回顾性分析2014年3月至2016年1月,杭州师范大学附属医院收治的338例初产妇,在产后7d时,采用爱丁堡产后抑郁量表(EPDS)评分筛选产后抑郁症患者,定义为抑郁组,并在非产后抑郁产妇中随机挑选同等数量受试者,定义为非抑郁组。统计产后抑郁发生率,比较产后抑郁组与非抑郁组的临床资料,产前、产后2d、产后7d皮质醇、雌二醇及孕酮的差异,最后探讨产后抑郁症与皮质醇、雌二醇、孕酮等指标间的相关性。计量资料的比较采用t检验,计数资料的比较采用χ~2检验,两因素相关采用pearson相关,产后抑郁症的多因素分析采用多元线性回归分析。结果在338例受试者中,检测出产后抑郁症患者42例,产后抑郁症的发生率为12.43%。产后抑郁组和非抑郁组文化程度的差异有统计学意义(P0.05)。产前,两组患者皮质醇、雌二酮、孕酮水平差异均无统计学意义(P0.05);产后2d,两组雌二酮、孕酮的差异有统计学意义(P0.05),而皮质醇的差异无统计学意义(P0.05);产后7d,两组间皮质醇、雌二醇、孕酮的差异均有统计学意义(P0.05)。Pearson相关分析显示,产后EPDS评分与产后2d雌二醇及7d雌二醇呈负相关(r=-0.693、-0.591,P0.01),与产后2d孕酮、7d孕酮、7d皮质醇呈正相关(r=0.734、0.366、0.324,P0.01),logistic回归分析显示,产后抑郁与产后2d雌二醇、产后2d孕酮及产后7d雌二醇相关(P0.05)。结论产后雌二醇水平下降过快,或孕酮维持较高水平是产后抑郁发生的危险因素,检测产后2d时的雌二醇及孕酮水平对于预测产后抑郁症的发生有重要意义。     

产褥期抑郁情绪的前瞻性研究

目的:了解产后3 d产后忧郁的发生及其在产后42 d的恢复情况,产后忧郁与产后抑郁症之间的关系及各自相关的影响因素。方法:应用爱丁堡产后抑郁量表(EPDS)和产妇一般情况调查表分别于产后3 d及42 d对667名无孕期并发症/合并症和精神疾患的产妇进行测评,用SPSS12.0统计分析软件对发生率以及相关影响因素进行统计分析。结果:产后3 d产后忧郁发生率为23.1%;产后42 d产后抑郁症发生率为6.3%;产后忧郁者有15.9%在产后42 d发展为产后抑郁症,占发生产后抑郁症的57.9%;有84.1%在产后42 d恢复正常,产后忧郁与产后抑郁症之间存在显著相关性。家庭支持等心理社会因素及经前期综合征等生物学因素和产后抑郁情绪密切相关;产后与家人关系状况、产后3 d EPDS分值及经前期综合征史与产后忧郁的恢复密切相关。结论:产后忧郁可能为产后抑郁症的先兆,对产后忧郁的及早筛查和干预对预防和降低产后抑郁症的发生率有重要的意义。     

产后抑郁影响因素分析

目的:了解产后抑郁症状的检出情况,探讨影响产后抑郁的因素。方法:采用随机抽样的方法,选择在本院进行产前检查并计划在该院分娩的孕晚期孕妇371例作为研究对象,对孕产妇进行孕晚期、产后1~3天及产后42~49天进行3次问卷调查。结果:产后42天抑郁症状检出率32.1%。经单因素分析,产后抑郁的影响因素包括:与公婆同住、不良孕产史、个性内向、神经质、孕期焦虑或抑郁、孕前家庭支持度、产后家庭支持度和孕期心理准备得分。多因素Logistic回归分析显示孕期焦虑或抑郁、孕期心理准备得分、产后家庭支持度和不良孕产史与产后抑郁的相关性有统计学意义。结论:本研究产后抑郁症状检出率与国内外的报道相符。孕期心理状况是发生产后抑郁症的一个预测因子;家人对孕产妇的关心和孕期心理准备充分是产后抑郁的保护因素;不良孕产史、个性不稳定、个性内向是产后抑郁的危险因素。可以在孕期进行产后抑郁症易患人群的筛查和干预,可有效预防产后抑郁症的发生。     

产前抑郁与产后抑郁症的相关性

目的  探讨产前抑郁与产后抑郁症的关系。 方法  选择银川市妇幼保健院与中卫市中医院2所医院的200名住院待产妇, 采用抑郁自评量表(self rating depression scale, SDS)与爱丁堡产后抑郁量表(Edinburgh postnatal depression scale, EPDS)分别调查产前与产后抑郁状况。 结果  200名产妇产前抑郁检出率为20.0%, 产后3 d抑郁检出率为26.0%, 产后42 d检出率为15.5%。有产前抑郁的产妇产后3 d(χ²=9.381, P=0.002)、产后42 d(χ²=11.923, P=0.001)抑郁检出率高于无产前抑郁者。Pearson相关分析显示, 产前SDS得分与产后3 d的EPDS得分、与产后42 d的EPDS得分均呈正相关(均有P < 0.05)。广义估计方程分析亦得出产前抑郁与产后3 d抑郁、产后42 d抑郁均呈正相关(均有P < 0.05)。多因素Logistic回归分析模型显示产前抑郁是产后3 d抑郁(OR=2.678, 95%CI:1.241~5.781, P=0.012)、产后42 d抑郁(OR=3.180, 95%CI:1.303~7.763, P=0.011)的危险因素。 结论  产前抑郁与产后抑郁症呈正相关, 产前抑郁增加了产后抑郁症的危险性。     

基于一所医院产后抑郁症的患病情况及其危险因素调查

目的:调查产后抑郁(PPD)的患病情况,分析PPD的危险因素,为PPD的预防和干预提供依据。方法:利用自制问卷和爱丁堡产后抑郁量表(EPDS),对2012年7～10月在北京市朝阳区一所医院分娩的300例产妇的基本情况和PPD情况进行调查。EPDS共包括l0个项目,得分范围为0～30分。本研究定义EPDS总分≥10分者为产后抑郁症。采用SPSS18.0软件对PPD的发生情况及危险因素进行分析。结果:本次调查时点内调查对象PPD发生率为24.33%。多因素logistic回归分析发现,"与婆家关系差"(OR=2.47,95%CI=1.120-5.44)、"孕前健康状况差"(OR=4.99,95%CI=1.561-15.93)、"怀孕影响目前工作或收入"(OR=1.79,95%CI=1.02-3.12)的产妇,PPD患病率较高。结论:当前PPD的发生率较高,心理原因是主要危险因素,产后良好的家庭支持和心理支持可降低PPD症的发生率。     

成都地区孕产妇孕晚期和产后抑郁随访研究

目的 随访成都地区孕产妇孕晚期和产后抑郁状态,比较不同时点抑郁率,分析孕晚期和产后抑郁的关系。方法 选择2013年10月~2014年2月,在四川大学华西第二医院门诊部进行产前检查的孕晚期妇女作为研究对象,以爱丁堡产后抑郁量表（Edinburgh postnatal depression scale,EPDS）为主要研究工具,分别在孕晚期、产后8周和18周评估抑郁症状。以13分为筛查有无抑郁症状的临界值。用广义估计方程分析不同时点抑郁率和EPDS得分,用单因素Logistic回归分析孕晚期抑郁和产后抑郁的关系。结果 共纳入2 057位孕晚期妇女,其中1 665例完成产后8周随访,1 440例完成产后18周随访。孕晚期、产后8周和18周抑郁率分别为13.8%、2.2%和1.7%,抑郁率间差异有统计学意义（χ2=181.448,P<0.001）。孕晚期抑郁与产后抑郁有关（OR=3.88,95%CI:2.17~6.94,P<0.001）。孕晚期得分（8.35±3.93）最高,产后8周（3.05±3.28）次之,产后18周（2.21±3.03）最低。孕晚期得分与产后8周、18周得分均呈正相关,相关系数分别为0.358和0.128。结论 随访人群孕晚期抑郁率高于产后抑郁率,且孕晚期抑郁与产后抑郁相关,孕晚期抑郁应被给予更多关注。     

重庆市万州区产后抑郁症的调查研究

目的:了解重庆市万州区产妇产后抑郁症的患病情况及可能的影响因素。方法:对2 000例产妇采用一般个人情况调查表及Edinburgh艾氏产后抑郁量表(EPDS)进行问卷调查。结果:万州区产妇产后抑郁症的患病率为33.93%,年龄较小的产妇、农村产妇患病率较高;与丈夫年龄差距在5～10岁者患病率较低;该次妊娠存在合并症、产妇经济收入较低、与丈夫和婆婆关系紧张、平时睡眠较差以及新生儿发育较差与产后抑郁症的发生有关。结论:产后抑郁症的发生与多种因素有关,医务人员及家属应关注孕产妇的身心状况,及早采取措施干预和治疗。     

Socio-Economic Determinants and Self-Reported Depressive Symptoms During Postpartum Period

The researchers' aims were to estimate the prevalence of postpartum depressive symptoms in Italy. Cross-sectional data from the survey, “Health and use of health care in Italy” were analyzed. The authors focused on 5,812 women, pregnant some time during five years before the survey. Multiple logistic regression was used to evaluate risk factors independently associated with postpartum depressive symptoms. Evaluation of seasonal trends was also performed.In the total sample, 23.5% (n = 1,365) reported having suffered postpartum depressive symptoms: 20.7% experienced baby blues, and 2.8% postpartum depression. Factors significantly associated with baby blues were, among others, living in northern or central areas (adjusted odds ratio [aOR] 1.88; 95%CI 1.57–2.15 and 1.40; 95%CI 1.20–1.63, respectively), history of depression (aOR 1.34; 95%CI 1.15–1.56), and attendance at antenatal classes (aOR 1.13; 95%CI 1.04–1.22). Factors significantly associated with postpartum depression were: anamnesis of depression (aOR 3.32; 95%CI 2.69–4.09), gaining more than 16 kg of weight during pregnancy (aOR 1.48; 95%CI 1.03–2.12), and undergoing a cesarean section (planned: aOR 1.56; 95%CI 1.05–2.29; unplanned: aOR 1.78; 95%CI 1.16–2.73). Multiparity was a protective factor both for baby blues (aOR 0.80; 95%CI 0.70–0.91), and postpartum depression (aOR 0.71; 95%CI 0.51–0.98). No clear seasonality was observed for postpartum depression, while for baby blues a certain aggregation of events was registered during the central months of the year. The authors' study highlighted variables associated with baby blues and postpartum depression to target screening for women for postpartum depressive symptoms.     

Is There a Role for the Family and Close Community to Help Reduce the Risk of Postpartum Depression in New Mothers? A Cross-Sectional Study of Turkish Women

OBJECTIVES: Postpartum depression is an important and under-diagnosed problem. The aims of this study were (1) to compare the prevalence of depressive symptomology in Turkish mothers who were 1-3 months postpartum with the prevalence of depressive symptomology in mothers who had not been pregnant for at least 1 year, (2) to identify risk factors associated with depression in both groups, and (3) to examine the effect of postpartum depression on breastfeeding by the mothers. DESIGN: Cross-sectional study SETTING: Well-baby clinic PARTICIPANTS: 326 women enrolled in January 2001; 163 were 1-3 months postpartum, and 163 had not been pregnant in the previous year. RESULTS: The prevalence of depressive symptomology in the postpartum and non-postpartum groups was 17% (28/163) and 24.5% (40/163), respectively; this was not statistically significant (P = 0.102). When we compared mean Beck Depression Inventory (BDI) scores, the difference between the two groups was statistically significant (10.75 +/- 8.06 and 12.63 +/- 8.81, respectively, P = 0.045). Premenstrual tension and a history of depression were risk factors for depressive symptomology in both groups. Three or more births and a history of induced abortion were risk factors for depressive symptomology in the non-postpartum group. In the postpartum group, the effect of depression on breast-feeding was not statistically significant (P = 0.7). The generalisability of the study results to the community is limited. CONCLUSION: In this study, the prevalence of depressive symptomology in the postpartum and non-postpartum groups did not show a significant difference, but the prevalence of depressive symptomology was high in both groups. Postpartum depression did not have a negative effect on breast-feeding. Lower BDI scores in the postpartum period may be the result of the protective factors of motherhood which is a respected status for women in populations where the preservations of traditions and customs are valued.     

Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice

OBJECTIVE: Data are scarce regarding the sociodemographic predictors of antenatal and postpartum depression. This study investigated whether race/ethnicity, age, finances, and partnership status were associated with antenatal and postpartum depressive symptoms. SETTING: 1662 participants in Project Viva, a US cohort study. DESIGN: Mothers indicated mid-pregnancy and six month postpartum depressive symptoms on the Edinburgh postpartum depression scale (EPDS). Associations of sociodemographic factors with odds of scoring >12 on the EPDS were estimated. MAIN RESULTS: The prevalence of depressive symptoms was 9% at mid-pregnancy and 8% postpartum. Black and Hispanic mothers had a higher prevalence of depressive symptoms compared with non-Hispanic white mothers. These associations were explained by lower income, financial hardship, and higher incidence of poor pregnancy outcome among minority women. Young maternal age was associated with greater risk of antenatal and postpartum depressive symptoms, largely attributable to the prevalence of financial hardship, unwanted pregnancy, and lack of a partner. The strongest risk factor for antenatal depressive symptoms was a history of depression (OR = 4.07; 95% CI 3.76, 4.40), and the strongest risk for postpartum depressive symptoms was depressive symptoms during pregnancy (6.78; 4.07, 11.31) or a history of depression before pregnancy (3.82; 2.31, 6.31). CONCLUSIONS: Financial hardship and unwanted pregnancy are associated with antenatal and postpartum depressive symptoms. Women with a history of depression and those with poor pregnancy outcomes are especially vulnerable to depressive symptoms during the childbearing year. Once these factors are taken in account, minority mothers have the same risk of antenatal and postpartum depressive symptoms as white mothers.