产后抑郁症发生率及相关因素分析

Analysis on incidence and effect factors of postpartum depression

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。

Objective： To explore the incidence of postpartum depression in Shenzhen, discuss the effect factors and early intervention methods of postpartum depression. Methods： 100 social health centers were selected as research point by random number table, 2 216 women who gave birth at Shenzhen from March 2007 to October 2007 were investigated by Center for Epidemiologic Studies Depression Scale （ CES - D） and normal health questionnaire, Logistic regression analysis was used to analyse the effect factors of postpartum depression. Results： The incidence of postpartum depression was 8.12%. The main risk factors were as follows： husband drinking problem, profession and education level, expectation of child gender, fear of childbirth, rapid change in body size after childbirth and low confidence in childcare （ P 〈 0. 01 ） . The protective factors were ： health care and mental care during the pregnancy period, sanitation education of postpartum family and social support. Conclusion： The postpartum depression should be paid more attention to, the prenatal health care should be strengthened, the postnatal visiting should be widely developed, the early forecast and monitoring of postpartum depression should be started, the early prediction of risk factors, the actively mental consultation and tutorship are important measures for maintain and accelerate the mental health of pregnant woman, provide ＂ third class prevention＂ and reduce the mortality of pregnant woman.