分娩方式与产妇产后抑郁关系研究

Study on the relationship between delivery mode and postpartum

目的:探讨不同分娩方式与产妇产后发生抑郁情绪的相关性。方法:对314例产妇(自然分娩组152例,自愿剖宫产组86例,指征剖宫产组76例)进行问卷调查。结果:术后3 d自然分娩组抑郁发生率为19.7%,自愿剖宫产组为51.1%,指征剖宫产组为48.7%。术后3 d自然分娩组抑郁发生率均低于自愿剖宫产组和指征剖宫产组(P<0.01);术后1周自然分娩组抑郁发生率为23.0%,自愿剖宫产组为34.9%,指征剖宫产组为44.7%,术后1周自然分娩组产后抑郁发生率也低于自愿剖宫产组和指征剖宫产组(P<0.01);自愿剖宫产组及指征剖宫产组术后3 d的抑郁自评问卷得分较术前均显著升高(P<0.01),而自然分娩组抑郁自评问卷得分无显著变化(P>0.05);自愿剖宫产组术后1周的抑郁自评问卷得分较术后3 d显著降低(P<0.01),而自然分娩组和指征剖宫产组无显著变化(P>0.05)。结论:自愿剖宫产组及指征剖宫产组产妇抑郁发生率均高于自然分娩组,自愿剖宫产组产妇术后1周抑郁情况显著缓解。指征剖宫产组产妇术后1周抑郁情况维持在术后3 d的高水平,是今后护理工作的重点人群。

Objective：To discuss the different between postpartum depression and delivery modes.Methods：314 parturient（natural delivery group 152 case,unnecessary cesarean section group 86 cases and necessary cesarean section group 76 cases） were investigated by questionnaires.Results： The occur rate of depression in natural delivery group was19.7%,23.0%,while 51.1%,34.9% for unnecessary cesarean section group and 48.7%,44.7% for necessary cesarean section group after 3 days and 1 week postpartum.The occur rate of depression in natural delivery group was lower than that in unnecessary cesarean section group and necessary cesarean section group（P0.01）.The BDI score of necessary and unnecessary cesarean section group enhanced after 3 days and the BDI score of unnecessary cesarean section group decreased significantly1 week while the natural delivery without significant changes（P0.05）.Conclusion： Postpartum depression rate of necessary and unnecessary cesarean section parturient were higher than natural delivery parturient and the depression after 1 week of unnecessary cesarean section parturient relieved.The depression of necessary cesarean section parturient after 1 week maintained as the third day level and is the focus of the nursing health education in future.