产后抑郁症影响因素的病例对照研究

Case-control Study on Risk Factors of Postpartum Depression

目的探讨影响产后抑郁发生的社会心理因素,为预防产后抑郁症提供理论依据。方法采用1:1配对的病例—对照流行病学研究设计,选择确诊的100例产后抑郁症患者为病例;同时选择就诊的非抑郁症产妇,以年龄(相差1岁以内)为配比变量,与病例1:1相匹配者为对照。通过问卷调查的方法收集2组人群的社会人口学特征、夫妻关系、母女关系、分娩情况、家庭经济收入及对婴儿性别的是否满意等信息。问卷的分析和统计采用单因素及多因素的条件logistic回归分析。结果产后抑郁症患者与丈夫关系融洽度低于对照组,且有统计学意义(OR=0.232,95%CI:0.103～0.526);对照组母女关系融洽度高于病例组,且有统计学意义(OR=0.590,95%CI:0.352～0.988);病例组孕期有负性生活事件的危险性高于对照组,且有统计学意义(OR=2.469,95%CI:1.098～5.553);产后抑郁症患者家庭经济收入稳定性低于对照组,且有统计学意义(OR=0.243,95%CI:0.093～0.634)。结论孕期发生负性生活事件可能增加孕妇发生产后抑郁症的危险性,产妇与丈夫及母亲关系融洽、家庭经济收入稳定可降低产妇产后抑郁症的发生。

[ Objective] To explore the social psychological factors that influences the occurrence of postpartum depression, and to provide theoretical evidence for the prevention of postpartum depression. [ Methods ] 1 ： 1 matching cases-- control epidemiological study design was adopted, 100 confirmed cases of postpartum depression were selected; I00 cases without postpartum depression were selected as control group, based on 1：1 matching principle, by age （a difference of less than 1-year-old） for the ratio variable. The 2 groups＇information of socio-demographic characteristics, marital relationship, mother-daughter relationships, childbirth, the family income and satisfaction with gender of the baby was collected by questionnaire survey. The questionnaires were analyzed by single factor and multi-factor conditional lo- gistic regression. [ Results] Compared with the control group, patients with postpartum depression tended to have worse relationships with their husband, the difference was significant {OR = 0. 232,95% CI：0. 103 - 0.526） ; to have worse mother-daughter relationship, the differ- ence was significant （ OR = 0. 590, 95% CI：0. 352 - 0. 988 ） ; to have higher risk factors of adverse life events during pregnancy, the difference was significant （OR =2.469, 95% Cl 1. 098 -5.553）, and to have lower stability of family economic income, the difference was significant （OR = 0. 243, 95% Cl： 0.093 -0. 634）. [ Conclusion] Adverse life events during pregnancy may increase the risk of postpartum depression. However, good relationships with husband and mother, and steady income can reduce the occurrence of postpartum depression.