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.

Status and related factors of postpartum depression in patients with second child

Objective To understand the status of postpartum depression ( PPD) in women with second child and discuss the related factors.Methods Using the method of random number table , 5 hospitals of third grade in Urumqi were randomly selected from March 1, 2016 to February 1, 2017.All pregnant women meeting inclusion criteria for second delivery were recruited as research objects . Questionnaires were distributed to them at 2 -7 days after delivery , including general information questioinnaires , Edinburgh postnatal depression scale (EPDS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and social support rating scale (SSRS) for measuring depression status .Related factors were also explored .Results A total of 861 questionnaires were distributed , and 824 were valid with effective rate of 97.86%.The prevalence rate of PPD in surveyed subjects was 34.71%.Influencing factors of PPD included gestational weight gain, nationality, occupation, family income, relationship between mother-in-law and daughter-in-law, whether accompany childbirth , whether complicating pregnancy diseases , satisfaction on newborn gender , whether early contact and early sucking , prenatal anxiety , prenatal depression , subjective support , objective support and support utilization , and the differences were statisically significant (χ2/t value was 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 and 10.113, respectively, all P<0.05).Multivariate logistic regression analysis showed that gestational weight gain ( OR=1.803,95%CI:1.075-3.837), no occupation (OR=2.357, 95%CI:1.384-4.253), prenatal anxiety (OR=9.883, 95%CI:6.154-8.231) and prenatal depression (OR=8.146,95%CI:5.332 -7.164) were risk factors of PPD, while good relationship between mother-in-law and daughter-in-law (OR=0.893,95%CI:0.572-0.835), satisfaction on newborn gender (OR=0.624, 95%CI:0.321-0.546), early contact and early sucking (OR=0.674,95%CI:0.441-0.683), good objective support (OR:0.412,95%CI:0.106-0.338) and good utilization of support (OR:0.583, 95%CI:0.239-0.482) were the protective factors.Conclusion Pregnant women with second child have higher prevalence of PPD , and the influencing factors are various .Government , related organizations and family members should give attention to PPD of them and provide adequate social support to improve the prevalence of postpartum depression in pregnant women with second child .