睡眠障碍与产后抑郁症之间的关联

Relevance research on the association between sleep disorders and postpartum depression

目的评估女性产后睡眠障碍和产后抑郁症的发生率,并探讨产后睡眠障碍对产后抑郁症发生的影响。方法采用横断面的研究设计,对2017年1月至2018年12月于解放军空军军医大学西京医院进行分娩后复查的252名产妇进行基础资料调查。采用匹兹堡睡眠质量量表(PSQI)和爱丁堡产后抑郁量表(EPDS)评估睡眠质量和产后抑郁症状。EPDS>9.5分定义产后抑郁症,根据产妇产后是否发生抑郁症,将252名产妇分为产后抑郁组与非抑郁组。结果本研究中产妇睡眠障碍和产后抑郁症的发生率分别为36.1%(91/252)和25.8%(65/252)。单因素分析中,产后抑郁组产妇PSQI总分显著高于非抑郁组[(8.43±2.37)分比(5.76±1.84)分;t=9.293,P<0.01];除睡眠时间分量表外,产后抑郁组PSQI各分量表得分均高于非抑郁组产妇(均P<0.01);产后抑郁组产妇睡眠障碍(PSQI>7分)发生率明显高于非抑郁组产妇[52.3%(34/65)比30.5%(57/187);χ^(2)=9.960,P=0.002]。多因素Logistic回归分析结果显示,在调整了社会人口统计学变量、围产期变量和妊娠期疾病变量后,产后睡眠质量和产后抑郁症之间的关联仍然显著(OR=2.35,95%CI:1.32~4.21)。结论产后睡眠障碍与产后抑郁症存在正向关联,对于存在产后睡眠障碍的产妇,应尽早提供干预措施,以减少抑郁症的发生风险。

Objective To evaluate the prevalence of postpartum sleep disorders and postpartum depression in women,and to explore the relationship between postpartum sleep disorders and postpartum depression.Methods A cross-sectional study design was used to investigate the basic data of 252 women who underwent reexamination after childbirth in Xijing Hospital from January 2017 to December 2018.The Pittsburgh Sleep Quality Index(PSQI)and the Edinburgh Postpartum Depression Scale(EPDS)were used to evaluate sleep quality and postpartum depressive symptom.EPDS>9.5 was defined postpartum depression.According to whether postpartum depression occurred,252 cases were divided into postpartum depression group and non-depression group.Rusults The prevalence of sleep disorders and postpartum depression were 36.1%(91/252)and 25.8%(65/252),respectively.In uni-variate analysis,the PSQI score of postpartum depression group was significantly higher than that of non-depression group[(8.43±2.37)vs(.5.76±1.84);t=9.293,P<0.01];Except for sleep time subscale,PSQI subscale scores of postpartum depression group were higher than those of non-depression group(all P<0.01);The prevalence of sleep disorder(PSQI>7)in postpartum depression group was significantly higher than that in non-depression group[52.3%(34/65)vs.30.5%(57/187);χ^(2)=9.960,P=0.002].Multivariate logistic regression analysis showed that the association between postpartum sleep quality and postpartum depression remained significant after adjusting for sociodemographic variables,perinatal variables and gestational disease variables(OR=2.35,95%CI:1.32-4.21).Conclusions Postpartum sleep disorders were positively associated with postpartum depression.Interventions should be provided as early as possible to reduce the risk of depression for women with postpartum sleep disorders.