二胎产妇产后抑郁状况及影响因素分析

目的探讨二胎产妇产后抑郁状况及其影响因素,为改善二胎产妇心理状况提供参考依据。方法选取2020年1月至9月在浙江大学医学院附属杭州市第一人民医院住院分娩的384例二胎产妇为研究对象。采用一般资料调查表、爱丁堡产后抑郁评价量表(EPDS)、社会支持评定量表(SSRS),对分娩后1周的二胎产妇产后抑郁状况进行调查,并分析影响二胎产妇产后抑郁状况的因素。结果263例二胎产妇产后抑郁的发生率为30.21%(116/384)。单因素分析显示,年龄、文化程度、有无工作、家庭人均月收入、与公婆关系、陪伴分娩、婴儿低体重、新生儿性别满意度、喂养方式、睡眠障碍、产前焦虑、产前抑郁、社会支持总分与二胎产妇产后抑郁的发生有关(χ²/t值分别为5.746、13.506、5.538、12.681、17.066、5.556、11.709、8.367、36.145、14.416、13.307、8.866、17.317,均P<0.05)。Logistic多因素回归分析显示,家庭人均月收入≤4000元(OR=1.693,95%CI:1.031~3.259)、睡眠障碍(OR=2.311,95%CI:1.364~4.810)、与公婆关系差(OR=3.267,95%CI:1.528~7.509)、产前焦虑(OR=7.913,95%CI:2.149~19.331)、产前抑郁(OR=4.057,95%CI:1.716~8.024)、新生儿低体重(OR=5.350,95%CI:2.130~11.356)、喂养方式(混合喂养:OR=1.785,95%CI:1.452~2.330;人工喂养:OR=2.091,95%CI:1.367~3.945)、社会支持水平(OR=3.835,95%CI:1.501~5.628)是影响二胎产妇产后抑郁状况的独立危险因素(均P<0.05)。结论二胎产妇产后抑郁的发生率较高且影响因素较为复杂,应针对高危因素开展个性化的宣教,积极给予系统的心理疏导,以减少产后抑郁的发生。

Analysis of postpartum depression and its influencing factors in parturient with a second child

Objective To investigate the states of postpartum depression and its influencing factors in parturient with a second child,so as to provide reference for improving the psychological status in parturient with a second child.Methods A total of 384 parturient with a second child,delivered in Hangzhou First People’s Hospital Affiliated to Medical College of Zhejiang University from January 2020 to September 2020,were selected as the research objects.The general information questionnaire,Edinburgh Postpartum Depression Rating Scale(EPDS)and Social Support Rating Scale(SSRs)were used to investigate the postpartum depression status of parturient with a second child at the first week after delivery,to analyze the influencing factors of postpartum depression in parturient with a second child.Results The incidence of postpartum depression in parturient with a second child was 30.21%(116/384).The univariate analysis showed that age,education degree,work status,monthly family income per capita,relationship with parents-in-law,accompany delivery,neonatal low birth weight,neonatal gender satisfaction,feeding style,sleep disorder,prenatal anxiety,prenatal depression,and total score of social support were related to the occurrence of postpartum depression(χ²/t=5.746,13.506,5.538,12.681,17.066,5.556,11.709,8.367,36.145,14.416,13.307,8.866 and 17.317,respectively,all P<0.05).Logistic regression analysis showed that,the monthly family income per capita lower than 4000 yuan(OR=1.693,95%CI:1.031-3.259),sleep disorder(OR=2.311,95%CI:1.364-4.810),the bad relationship with parents-in-law(OR=3.267,95%CI:1.528-7.509),prenatal anxiety(OR=7.913,95%CI:2.149-19.331),prenatal depression(OR=4.057,95%CI:1.716-8.024),neonatal low birth weight(OR=5.350,95%CI:2.528-7.509),feeding style(mixed feeding:OR=1.785,95%CI:1.452-2.330,artificial feeding:OR=2.091,95%CI:1.367-3.945),social support level(OR=3.835,95%CI:1.501-5.628)were the independent risk factors of postpartum depression in parturient with a second child(all P<0.05).Conclusion The incidence of postpartum depression is relatively high and it’s influencing factors are complex.Individualized education should be carried out according to the high-risk factors,and systematic psychological counseling should be actively given to reduce the incidence of postpartum depression.