产后抑郁症的相关因素分析及其与γ-氨基丁酸的相关性

The analysis of the risk factors and the relationship between GABA and postpartum depression

目的探讨产后抑郁症(PPD)的高危因素及其与γ-氨基丁酸(GABA)的关系。方法徐州某三甲医院妇产科住院的足月孕妇被招募进行这项前瞻性纵向研究,分别于住院前及产后4周对产妇进行血GABA水平的检测。采用自制的基本情况量表了解产妇基本情况,通过爱丁堡产后抑郁量表(EPDS)将其划分为PPD组和非PPD组,分析PPD发生情况及相关影响因素。结果抑郁组13例,对照组64例。单因素方差分析结果显示,两组在经济条件、家庭关系、夫妻关系、喂养方式及新生儿疾病方面的差异具有统计学意义;进一步的多因素Logistic回归分析结果表明,家庭关系不融洽、夫妻关系差、未进行母乳喂养与产妇发生PPD有重要关系。两组产后4周GABA水平与产前比较差异均具有统计学意义,产后4周PPD组GABA水平明显高于非PPD组,两组产前的差异无统计学意义,EPDS与GABA水平呈正相关(r=0.348,P<0.05)。结论产后抑郁症由多种因素共同作用,与神经递质GABA水平的异常改变相关,早期关注产妇危险因素及提前检测产妇神经递质水平,有利于减少产后抑郁的发生。

Objective To investigate the relationship between high risk factors of postpartum depression and postpartum depression and gamma-aminobutyric acid(GABA).Methods Full-term pregnant women from the Department of Obstetrics and Gynecology,General hospital of Xuzhou were recruited for this prospective longitudinal study.Maternal blood GABA levels were measured before and 4 weeks after delivery.Use the self-made basic situation scale to understand the basic situation of maternity,Through the Edinburgh Postnatal Depression Scale(EPDS),it was divided into PPD(postpartum depression)group and non-PPD group to analyze the occurrence of PPD and related influencing factors.Results There were 13 patients in the depression group and 64 patients in the control group.The results of oneway analysis of variance showed that the two groups had statistical differences in economic conditions,family relationship,husband-and-wife relationship,feeding methods and neonatal diseases.Further multivariate logistic regression analysis showed that bad family relationships,poor conjugal relationship,non Breastfeeding has an important relationship with maternal PPD.The levels of GABA in prenatal and postpartum 4 weeks were significantly different between the two groups.The PPD group was significantly higher than the non-PPD group.There was no significant difference between the two groups preantal.EPDS was positively correlated with GABA level(r=0.34&P<0.05).Conclusions Postpartum depression is caused by a combination of factors,which are associated with abnormal changes in neurotransmitter GABA levels.Early attention to maternal risk factors and early detection of maternal neurotransmitter levels could reduce postpartum depression.