产妇精神因素对分娩方式产后出血及产后抑郁关系的探讨

Study of the effect of psychic factors on delivery mode and postpartum hemorrhage and after-birth depression

目的 观察产妇精神状态 (焦虑与抑郁 )与分娩方式、产后出血、产后抑郁症的关系。方法 12 2例健康初产妇以汉密顿焦虑量表 (HAS)和抑郁量表 (HDS)评定精神状态 ,所有产妇以产科常规进行分娩而不进行干预 ,观察其分娩方式、产后出血状况、产后抑郁情况。按分娩方式不同分为剖宫产组、钳产组及顺产组 ;按产后出血不同分产后出血组及无产后出血组 ;按产后有无抑郁症分为产后抑郁组和无产后抑郁组。结果 12 2例产妇焦虑发生率 3 5 .1%,抑郁发生率 2 8.4%,焦虑并抑郁发生率 16.7%。剖宫产组、钳产组的焦虑评分及抑郁评分明显高于顺产组 ,而剖宫产组、钳产组间则差异无显著性 ;产后出血组焦虑及抑郁评分亦明显高于无产后出血组。产后抑郁组焦虑及抑郁评分亦有明显高于无产后抑郁组。结论 焦虑状态与抑郁状态是增加助产率。

Objective To investigate the relationship between psychic factors (anxiety and depression) and delivery mode,postpartum hemorrhage as well as after birth depression.Methods 122 healthy primiparae were involved in the study,whose mental states were evaluated according to Hamilton anxiety scale (HAS) and Hamilton depression scale (HDS).The delivery course of all women were processed routinely without interference.Delivery mode and postpartum hemorrhage and after birth depression were observed.The pregnant women were divided into cesarean section group,forceps group and spontaneous group according to different delivery mode,and hemorrhage group and no hemorrhage group according to the state of hemorrhage after labor.Results Among the whole primiparae,anxious rate was 35.1%,depression rate was 28.4%,both anxious and depression rate was 16.7%.The anxious scores and depression scores in cesarean section group and forceps groups were higher than those of spontaneous group,however,there was no significant difference between cesarean section group and forceps group.The two scores were higher in hemorrhage group than those of no hemorrhage group.The anxious scores and depression scores in cesarean section group and forceps group were higher than those in spontaneous group,however,there was no significant difference between cesarean section group and forceps group.The two scores were higher in depression group than that of no depression group.Conclusion Anxious and depressive state may be one of the factors causing high assistant labor rate,postpartum hemorrhage and after birth depression.