高危妊娠孕妇产后抑郁的危险因素分析

Analysis of risk factors of postpartum depression in high-risk pregnant women

目的探讨高危妊娠孕妇产后抑郁的危险因素,为高危妊娠孕妇产后抑郁干预提供理论参考。方法选取2019年1—12月妇产科产检的高危妊娠孕妇319例作为研究对象,产后2周内,以《精神障碍诊断与统计手册第四版》轴Ⅰ障碍临床定式检查-病人研究版(SCID-I/P)为依据对患者进行筛选,以发生抑郁患者67例为病例组;未发生抑郁患者252例为对照组。收集其临床资料,采用单因素及多因素Logistic回归分析,筛选产后抑郁的影响因素。结果单因素分析结果显示,两组孕妇在中文版产前风险问卷(ANRQ-C)得分、合并症、夫妻关系、年龄方面比较,差异有统计学意义(P<0.05)。以产妇发生产后抑郁为因变量,以单因素分析中有统计学意义的分析因素为自变量,进行Logistic回归分析,结果显示,ANRQ评分、夫妻关系、年龄是产后抑郁的独立危险因素(P<0.05)。结论高危妊娠孕妇易发生产后抑郁,影响因素较多,ANRQ、夫妻关系、年龄是妇产后抑郁的独立危险因素,对高危人群要加强心理疏导,及早发现此类产妇,协助医生给予及时干预或遵医嘱给予药物治疗,改善产妇心理健康状态。

Objective To explore the risk factors of postpartum depression in high-risk pregnant women,and to provide theoretical reference for the intervention of postpartum depression in high-risk pregnant women.Methods A total of 319 high-risk pregnant women undergoing obstetrics and gynecology obstetrics from January to December 2019 were selected as the study objects.Within 2 weeks after delivery,the structured clinical interview for"Diagnostic and Statistical Manual of Mental Disorders Fourth Edition"axis I-patient research edition(SCID-I/P)was selected as the study objects.According to the screening of patients,67 patients with depression were regarded as a case group;252 patients without depression were regarded as a control group.The clinical data was collected,and single factor and multivariate Logistic regression analysis were used to screen the infl uencing factors of postpartum depression.Results The univariate analysis showed that there were statistically signifi cant diff erences between the two groups of pregnant women in the Chinese version of the antenatal risk questionnaire(ANRQ-C)score,comorbidities,husband and wife relationship,and age(P<0.05).The postpartum depression of the parturient was used as the dependent variable,and the statistically significant factors in the univariate analysis were used as independent variables to perform Logistic regression analysis.The results showed that ANRQ score,husband and wife relationship,and age were the independent risk factors for maternal postpartum depression(P<0.05).Conclusion The pregnant women with high-risk pregnancy were prone to postpartum depression,and there were many infl uencing factors.The ANRQ,husband and wife relationship,and age were the independent risk factors for postpartum depression.Psychological counseling should be strengthened for high-risk groups,early detection of such women,and assist the doctor to intervene in time or give medication according to the doctor's advice to improve the mental health of the lying-in woman.