北京城六区产妇产后一年体质量变化状况与产后抑郁症的相关性

Correlation between body mass change and postpartum depression in central six districts of Beijing

目的:了解和分析北京城六区产后1年产妇的体质量变化情况,分析体质量因素与产后抑郁(PPD)的相关性。方法:以2017年11至12月在北京城六区10家社区卫生服务中心登记的424例产妇为研究对象,从孕产妇保健手册及社区母子健康档案了解并记录孕前体质量、身高、年龄等一般情况及分娩方式、产次、合并症等围产信息,并在产后1年的随访中,收集产妇当前体质量、婴儿喂养方式和产妇的照护状况。采用爱丁堡产后抑郁量表(EPDS)获取产妇心理状况相关信息,并分析评价。结果:以EPDS≥13分计,424名产妇PPD发生率为27.83%。产后有11.32%的女性发生了体质量降低,42.46%的产妇发生高程度的体质量滞留,其中体质量滞留5~10 kg者占30.90%,体质量滞留10 kg以上者占11.56%。在体质量因素与PPD的多元Logistic回归分析中,调整年龄、受教育程度和家庭月收入,以及与PPD发生相关的社会因素后,产后体质量合理增加0~5 kg(OR=0.492,95%CI:0.244~0.991,P=0.047)是PPD发生的保护因素。产后1年的当前BMI与PPD无关。结论:产妇的体质量变化可能与PPD的发生相关,应针对高危人群加强干预,预防和减少PPD的发生。

Objective:To investigate the change of women’s body mass one year after delivery,and to discuss the correlation between body mass and postpartum depression(PPD).Methods:An epidemiological investigation was conducted on 424 postpartum women who set up files after delivery at 10 community health service centers in central 6 districts of Beijing from November to December,2017.The general information including pre-pregnancy body mass,age and height,and perinatal information including delivery mode,delivery times and complication were obtained by records extraction from Maternal Health Manual and Community Maternal and Child Health Records.In the one year after delivery follow-up,the current body mass,infant feeding mode and maternity care information were obtained and the Edinburgh Postnatal Depression Scale(EPDS)was used to assess the status of depression.The correlation of body mass change with PPD were estimated by logistic regression.Results:27.83%of postpartum women were depressed according to the EPDS cut-off score≥13.11.32%of postpartum women had body mass loss,and 42.46%had a high degree of weight retention,of which 30.90%had a weight retention of 5-10 kg and 11.56%had a weight retention of more than 10 kg.The results of multiple logistic regression analysis showed that weight retention of 0-5 kg(OR=0.492,95%CI:0.244-0.991,P=0.047)was a positive factor of PPD after statistical adjustment for age,education,monthly family income,and society correlation factors.There current BMI of one year postpartum was not related to PPD.Conclusion:Body mass-related variables may be risk factors of PPD.Intervention should be strengthened according to relevant risk factors to prevent PPD.