高龄产妇的体重指数、孕期增重及血清生化对产后抑郁的影响

Effects of BMI,pregnancy weight gain and serum biochemistry on postpartum depression in elderly parturient women

目的:探讨高龄产妇的体重指数(BMI)、妊娠期体重增重及血清生化指标(雌二醇、5-羟色胺、孤啡肽)水平对产后抑郁(PPD)的影响。方法:分析413例高龄产妇的PPD发生率,比较抑郁组与对照组的BMI、孕期增重、血清生化对PPD的影响。结果:高龄产妇PPD发生率为19.13%,PPD发生率由高至低为BMI超重组27%>肥胖组25%>低体重组17%>正常组10%(χ^2=14.027,P<0.05);按IOM孕期增重标准,PPD发生率由高至低是超标组(32.3%)>低于标准组(15.6%)>正常组(12.3%)(χ^2=21.650,P<0.01);抑郁组E2、5-HT显著低于对照组(P<0.05),孤啡肽显著高于对照组(P<0.05);Logistic回归分析显示血清E2和5-HT(OR<1),产前BMI、孕期增重、孤啡肽升高(OR>1)是产后抑郁的独立影响因素。结论:高龄产妇的BMI和孕期增重对PPD有预测作用,血清E2下降、5-HT下降、孤啡肽升高影响PPD的发生。

Objective:To investigate the relationship between postpartum depression(PPD)and BMI,gestational weight gain and serum levels of estradiol,5-HT,and orphanin fq.Methods:The incidence of PPD in 413elderly pregnant women was analyzed,the effect of BMI,pregnancy weight gain,serum biochemical on PPD in two groups were compared.Results:The incidence of PPD was 19.13%in elderly pregnant women.According to BMI grouping,the incidence of PPD was from high to low:BMI overweight 27%>BMI obesity 25%>BMI low weight,17%>BMI normal,10%.Chi-square was 14.027(P<0.05).According to IOM pregnancy weight gain standard,the incidence of PPD from high to low was exceed limit(32.3%)>lower the limit>normal group(12.3%).Chi-square were 21.650,P<0.01.E2and 5-HT in the depression group were significantly lower than control group(P<0.05),and the levels of orphanin fq were significantly higher than control group(P<0.05).Logistic regression analysis showed that increased serum E2and increased 5-HT were independent favorable factors for postpartum depression(OR<1),while prenatal BMI,pregnancy weight gain and increased E2orphanin were independent risk factors for postpartum depression(OR>1).Conclusion:BMI and pregancy weight gain of elderly pregant women can predict PPD,Serum E2,5-HT and can influence PPD.