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围生期抑郁的发生风险及其影响因素分析 被引量:13

Risk factors of perinatal depression in pregnant women
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摘要 目的探讨孕妇围生期抑郁的发生风险及其影响因素。方法选取2020年1至10月在杭州市妇产科医院建卡并计划分娩的孕妇5214例。收集受试对象人口学特征、个人史、婚育史、配偶个人史、家庭支持、睡眠质量、围生期并发症及分娩经历等资料,分别在孕晚期(≥28周)及产后6周应用爱丁堡产后抑郁量表(EPDS)进行抑郁筛查,以EPDS评分≥10分为抑郁筛查阳性,采用多因素logistic回归分析影响孕妇孕期及产后抑郁发生的因素。结果共纳入孕期抑郁筛查孕妇5214例,其中1400例随访至产后6周并完成产后抑郁筛查。孕期抑郁筛查阳性率为28.10%,产后抑郁筛查阳性率为31.93%。多因素logistic回归分析结果显示离婚,非计划内怀孕,本人孕期偶尔饮酒史,孕早期有轻微、严重或极其严重孕吐史,孕期睡眠质量欠佳、一般或很差,既往抑郁症史,既往焦虑症史均是孕期抑郁发生的危险因素(均P<0.05);而年龄≥35岁、全职或自由职业、孕期无羊水量异常史、孕期有家庭支持均是孕期抑郁发生的保护因素(均P<0.05)。产后睡眠质量欠佳、一般或很差及孕期抑郁风险筛查阳性均是产后抑郁发生的危险因素(均P<0.05);本次分娩体验感觉值得、符合预期或满意均是产后抑郁发生的保护因素(均P<0.05)。结论围生期抑郁的发病风险与孕产妇职业、年龄、婚育情况、家庭支持、睡眠质量、产科并发症以及分娩体验等密切相关,临床上应当注重孕期抑郁高危人群的筛查和防治,加强孕妇优质护理服务及人文关怀工作。 Objective To analyze the risk factors of perinatal depression in pregnant women.Methods A total of 5214 women participated in late pregnancy depression screening in Hangzhou Women's Hospital from January to October 2020,of whom 1400 cases were followed up to 6 weeks postpartum and completed postpartum depression screening.The data of demographic characteristics,personal history,marriage and childbirth history,spouse's personal history,family support,sleep quality,perinatal complications and delivery experience of were collected.Edinburgh postnatal depression scale(EPDS)was used to screen depression in the third trimester(≥28 weeks)and the sixth week after delivery respectively.The score of EPDS≥10 was regarded as positive for depression screening.Multivariate logistic regression analysis was used to explore the risk factors of depression during pregnancy and postpartum.Results The positive rate of depression screening during pregnancy was 28.10%and the positive rate of postpartum depression screening was 31.93%.Multivariate logistic regression analysis showed that divorce,unplanned pregnancy,occasional alcohol drinking during pregnancy,mild alcohol drinking during early pregnancy,history of severe emesis or extremely severe emesis,poor,moderate or very poor sleep quality during pregnancy,previous depression and anxiety were risk factors for depression during pregnancy(all P<0.05).Age≥35 years old,full-time job or freelance,no abnormal amniotic fluid volume during pregnancy,family support during pregnancy were protective factors(all P<0.05).Poor postpartum sleep quality,moderate sleep quality or very poor sleep quality,and positive pregnancy depression risk screening were risk factors for postpartum depression(all P<0.05).Worth of childbirth experience,meeting expectations,satisfaction were protective factors for depression during pregnancy(all P<0.05).Conclusion The risk of perinatal depression is closely related to the occupation,age,marriage and childbirth,family support,sleep quality,obstetric complications,and delivery experience of pregnant women.The screening of high-risk groups and prevention of pregnancy depression should be enhanced,the high-quality nursing service and humanistic care of pregnant women should be strengthened.
作者 曾婉婷 徐萌艳 段陈迟 张芝银 周敏聪 ZENG Wanting;XU Mengyan;DUAN Chenchi;ZHANG Zhiyin;ZHOU Mincong(Department of Outpatient and Emergency,Hangzhou Women's Hospital,Hangzhou 310008,China)
出处 《浙江医学》 CAS 2021年第13期1409-1414,共6页 Zhejiang Medical Journal
基金 上海交通大学医工交叉研究基金项目(YG2020YQ29)。
关键词 围生期抑郁 影响因素 爱丁堡产后抑郁量表 Perinatal depression Influencing factors Edinburgh postnatal depression scale
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