保健随访对降低产后抑郁症发生率的影响

Effect of door-to-door health education guidance after delivery on reducing incidence of postpartum depression

目的了解产后特需上门一对一健康教育指导对产后抑郁症发生率的影响。方法抽取海淀区妇幼保健院2008年9月到2010年4月自愿接受产后特需康复上门一对一指导的311例产妇为干预组，同时抽取同期6家地段保健科未接受特需康复上门一对一指导的产妇175例为对照组。用抑郁自评量表于产后1周左右和产后1个月左右两次评估抑郁的发生情况。结果抑郁指数在干预组与对照组中差异有统计学意义（x2=8．810，P=0．012）。总体评估干预组与对照组抑郁自评量表抑郁得分差异有统计学意义（Z=-3．956，P=0．000）。干预组中第1次评估抑郁发生率为31．2％（97例）；第2次评估抑郁发生率为23．5％（73例），干预组在指导前后抑郁率的统计有显著性差异（r=4．663，P=0．038〈0．05）。对照组第1次评估抑郁发生率为24．6％（43例）；第2次抑郁发生率为25．7％（45例），对照组两次评估差异无统计学意义（r=0．061，P=0．805）。结论健康教育指导可有效地降低产后抑郁的发生率。

Objective To investigate effect of door-to-door health education guidance on prevalence of postpartum depression（PPD）. Methods From September, 2008 to April, 2010, 331 parturient women who were willing to accept door-to-door health education guidance in Haidian Maternal and Child Health Hospital were selected in intervention group and 175 pupueral women who didn＇ t receive any door- to-door health education guidance in other 6 district hospitals were selected in control group. Self-rating depression scale（SDS） was used to evaluate postpartum depression of the pupueral women at one week and one month after delivery respectively. Results There was significant difference in depression index between the two groups（x2 = 8. 810, P = 0. 012）. And there was a significant difference in total SDS scores between the two groups（ Z = - 3. 956, P = 0. 000）. In the intervention group, the incidence rate of PPD at the first evaluation was 31.5% （97 cases） and that in the second evaluation was 23.5% （73 cases）, and there was a significant difference befor and after the ~ ~ 2 mtervenuon（X =4. 663, P =0. 038）. In the control group, the incidence rate of PPD at the first evaluation was 24.6% （43 cases）and that at the second evaluation was 25.7% （45 cases）, there was no significant difference between the two times of evaluation （x2 = 0.061, P = 0.805）. Conclusion Health education guidance could reduce incidence rate of PPD effectively.