北京市产后抑郁状态的影响因素分析

Influencing factors of postpartum depression in Beijing

目的 分析北京市产后抑郁状态的影响因素,为早期识别高风险孕妇,尽早进行心理健康指导与干预提供依据。方法 选取分娩时间在2020年1月1日至2020年12月31日期间,在北京市领取母子健康手册(孕产保建档案)并进行产后心理健康评估的孕产妇,对产后抑郁状态进行统计分析。结果 北京市产后抑郁状态检出率为5.18%。单因素分析结果显示有产后抑郁状态的孕产妇与无产后抑郁状态孕产妇在年龄、户籍、婚姻状况、受教育程度、工作状态、BMI、分娩方式、围产儿结局,以及是否多胎妊娠、初产妇、既往精神疾病史、产前抑郁状态、早产、低出生体重儿、新生儿重度窒息方面差异均有统计学意义(χ^(2)=4.398~1 600.00,P<0.05);多因素分析结果显示低龄(<25岁)(OR=1.273,95%CI:1.023~1.584)、较低的受教育程度(高中及以下)(OR=1.248,95%CI:1.072~1.453)、初产妇(OR=1.417,95%CI:1.235~1.627)、消瘦(BMI<18.5kg/m~2)(OR=1.274,95%CI:1.022~1.589)、产前抑郁状态(OR=6.680,95%CI:5.799~7.694)、剖宫产(OR=1.231,95%CI:1.064~1.423)、早产(OR=2.468,95%CI:1.199~5.076)是产后抑郁状态的危险因素(P<0.05)。结论 北京市产后抑郁状态发生率在我国处于较低水平,临床中应高度重视具有产后抑郁状态危险因素的孕产妇,尽早进行孕产妇心理评估,做好孕产妇心理健康宣教及相应干预,以保障母婴心身健康。

Objective To analyze the influencing factors of postpartum depression in Beijing, so as to provide evidence for early identification of high-risk pregnant women and early mental health guidance and intervention.Methods Pregnant women who received the maternal and child health manual(maternity protection archives) and underwent postpartum mental health assessment in Beijing after delivery from January 1,2020 to December 31,2020 were selected, and the status of postpartum depression was analyzed.Results The detection rate of postpartum depressive symptoms in Beijing was 5.18%.The univariate analysis showed that there were significant differences in age, household registration, marital status, education level, working status, body mass index(BMI),delivery mode, perinatal outcome, multiple pregnancy, primipara, history of mental illness, prenatal depression, premature birth, low birth weight infants and severe neonatal asphyxia between pregnant women with and without postpartum depression(χ^(2)=4.398-1600.00,P<0.05).The multivariate analysis showed that younger age(<25 years old)(OR=1.273,95%CI:1.023-1.584),lower education level(high school or below)(OR=1.248,95%CI:1.072-1.453),primipara(OR=1.417,95%CI:1.235-1.627),emaciation(BMI<18.5 kg/m~2)(OR=1.274,95%CI:1.022-1.589),prenatal depression(OR=6.680,95%CI:5.799-7.694),cesarean section(OR=1.231,95%CI:1.064-1.423) and preterm birth(OR=2.468,95%CI:1.199-5.076) were risk factors for postpartum depression(P<0.05).Conclusion The incidence of postpartum depression in Beijing is at a low level in China.In clinical practice, we should pay more attention to pregnant women with risk factors for postpartum depression, carry out psychological evaluation as soon as possible, and do a good job in maternal mental health education and intervention, so as to protect the maternal and infant physical and psychological health.