新冠肺炎疫情管控对初产妇产后抑郁的影响

目的探讨新型冠状病毒肺炎疫情管控对初产妇产后抑郁症状的影响。方法选取2020年7月至12月足月单胎头位选择阴道分娩初产妇656例,记录患者的一般资料,采用自制问卷调查影响产妇心理变化的相关因素,选择爱丁堡产后抑郁量表(EPDS)评估产后7〜14 d抑郁状况,并对出现产后抑郁的主要影响因素进行相关分析。结果新冠肺炎疫情管控下,产妇产后抑郁(EPDS评分≥11分)发生率为18.1%。Logistic回归分析显示:担心感染新冠病毒肺炎(OR=1.706,95%CI 1.002〜2.906,P=0.049),医疗机构封闭式管理(OR=3.394,95%CI 2.251〜5.117,P<0.01),医院限制陪同人员数量(OR=7.202,95%CI 1.160-2.591,P<0.007),分娩时严重疼痛(VAS评分≥7分)(OR=1.939,95%CI 1.284〜2.928,P=0.002),戴口革经常呼吸困难(OR=6.472,95%CI4.216〜9.934,P<0.01),睡眠质量(睡眠<5 h,失眠)(OR=9.053,95%CI 5.807〜14.114,P<0.01),担心婴儿防护问题(OR=1.789,95%CI 1.142〜2.803,P=0.011),存在母乳喂养相关问题(OR=2.056,95%CI 1.286〜3.286,P=0.003)是新型冠状病毒肺炎疫情管控对初产妇产后抑郁症状的危险因素。有家人陪伴导乐(OR=0.467,95%CI:0.248-0.880,P=0.019)为疫情管控下初产妇产后抑郁症状的保护因素。结论产后抑郁的发生与新型冠状病毒肺炎疫情导致的多种危险因素叠加明显相关,为预防新冠病毒肺炎疫情期间产后抑郁的发生提供参考。

Objective To evaluate the effect of Coronavirus Disease2019(COVID-19)control on postpartum depression of primipara.Methods A total of 656 perinatal women were selected,who were delivered in our hospital from July 1 to December 2020.The general infonnation of them was recorded.Self-made questionnaires were used to investigate the relevant factors affecting the maternal psychological changes.The Edinburgh Postpartum Depression Scale(EPDS)was used to assess depression from 7 days to 14days after delivery.The main factors affecting postpartum depression were analyzed.Results Under the control of COVID-19,the incidence of postpartum depression(EPDS score≥7)in our hospital was 18.1%.Binary Logistic regression analysis indicated that Concerns about the risk of COVID—19(OR=1.706,95%CI 1.002~2.906,P=0.049),closed management of medical institutions(OR=3.394,95%CI 2.251~5.117,P<0.01),hospital limit of escort numbers(OR=7.202,95%CI 1.160~2.591,P<0.007),severe pain at delivery(OR=1.939,95%CI 1.284~2.928,P=0.002),frequent dyspnea with masks(OR=6.472,95%CI 4.216—9.934,P<0.01),sleep quality(Sleep<5 h,insomnia)(OR=9.053,95%CI 5.807~14.114,P<0.01),concerns about baby protection(OR=1.789,95%CI 1.142~2.803,P=0.011),breastfeeding related problems(OR=2.056,95%CI 1.286~3.286,P=0.003)were the main risk factors for postpartum depression during COVID-19 epidemic control.Conclusion The occurrence of postpartum depression is significantly correlated with the superposition of multiple risk factors caused by the COVID—19 epidemic.These provide an effective prevention strategy for preventing the postpartum depression during the control of COVID-19.