产妇4027例重度产后抑郁检出情况分析

Prevalence of major postpartum depression in 4027 parturient women

目的探讨产后不同阶段的抑郁发生情况及其相关决定因素。方法选取2016年3-6月在合肥市接受产后3~7 d访视和产后42 d检查的4 027例产妇作为研究对象,采用自行设计的调查问卷和爱丁堡产后抑郁量表进行调查。多因素非条件logistic回归分析比较产后不同阶段重度抑郁的相关决定因素。结果产后3~7 d和产后42 d抑郁总检出率分别为22.3%和11.9%,重度抑郁的检出率分别为5.7%和3.6%,总体重度抑郁的检出率为7.5%(303/4 027)。产后不同时间段重度抑郁的检出率和决定因素不同。无职业、初产(OR=0.674)、早产(OR=2.588)、产后3~7 d超重/肥胖(OR=1.448)、产后3~7 d与家人的关系不佳(OR=2.790)、婴儿出生健康状况不佳(OR=12.424)和婴儿42 d健康状况不佳(OR=9.100)是产后总体重度抑郁发生的主要决定因素。结论产后不同阶段产妇的重度抑郁水平呈动态变化,重度产后抑郁的发生是多种因素共同作用的结果;应对特定的高危人群开展针对性健康教育及心理咨询。

Objective To investigate the prevalence of major postpartum depression and related determinants at different stages of postpartum.MethodA total of 4027 women who received postnatal visit during 3 to 7 postnatal days and medical checkup at 42 postnatal days between March to June 2016,were selected as the research objects from Hefei City.A self-designed questionnaire was used to collect women’s basic socio-economic and obstetric information.Edinburgh postnatal depression scale was adopted to assess women’s postnatal depression level.Logistic regression model was set up to investigate the determinants of major postpartum depression in different postnatal periods.ResultsThe prevalence of postpartum depression was 22.3%and 11.9%,respectively at 3~7 postnatal days and 42 postnatal days.Prevalence of major postpartum depression was 5.7%and 3.6%,respectively.The overall prevalence of major depression was 7.5%.Different prevalence and determinants were found in major postpartum depression at different periods.No occupation,primiparity(OR=0.674),preterm birth(OR=2.588),overweight/obesity(OR=1.448)and relationships with family at 3~7 postnatal days(OR=2.790),infants’unhealthy status at birth(OR=12.424)and at 42 postnatal days(OR=9.100)was the main determinants of overall major postpartum depression.ConclusionsThe levels of severe depression of postpartum women in different stages of postpartum are dynamic changes.Multiple determinants caused women’s major postpartum depression.Targeted health education and mental counseling should be carried out towards high-risk populations.