北京地区产后妇女抑郁状况及其影响因素分析

The prevalence and risk factors of postpartum depression among women in Beijing

目的 分析北京地区产后2年内妇女产后抑郁症的发生情况及其影响因素。方法 以2018年11月至12月期间在北京城六区的10家社区卫生服务中心登记的产后2年内的554例妇女为研究对象,采用自制的调查问卷收集产妇的一般资料及相关因素,采用爱丁堡产后抑郁量表(EPDS)中文版诊断产后抑郁症(PPD),分析产后抑郁的影响因素。结果 根据EPDS产后抑郁症诊断标准,产后抑郁患病率为29.42%(163/554)。Logistic回归分析结果显示,有准备/计划的怀孕(OR=0.240,95%CI:0.131~0.439,P<0.001)、月子里和出月子后家属的照护(月子里:OR=0.247,95%CI:0.078~0.782,P=0.017;出月子:OR=0.350,95%CI:0.192~0.636,P=0.001)均可降低发生产后抑郁的风险;丈夫及家人对生男孩的期盼(OR=2.948,95%CI:1.882~4.617,P<0.001)、宝宝6个月内混合喂养(OR=2.032,95%CI:1.343~3.076,P=0.001)、赞成母乳喂养但不能坚定实施(OR=1.800,95%CI:1.201~2.697,P=0.004)、宝宝健康状况遇到问题(OR=2.815,95%CI:1.724~4.598,P<0.001)均增加了PPD的发生风险。结论 北京地区产后抑郁患病率高,且与多种因素相关;应针对相关危险因素加强干预,以预防和减少产后抑郁的发生。

Objective To analyze the prevalence and risk factors of postpartum depression among women within 2 years after delivery in Beijing.Methods A total of 554 women within 2 years after delivery who set up files at 10 community health service centers in the 6 districts of Beijing from November to December, 2018 were selected as the study subjects.Self-made questionnaire was used to investigate the basic information and related factors of parturient women, and the Chinese version of Edinburgh Postnatal Depression Scale(EPDS) was used to diagnose postpartum depression(PPD).The influencing factors of PPD were analyzed.Results According to the EPDS diagnostic criteria for postpartum depression, the prevalence of postpartum depression was 29.42%(163/554).Logistic regression analysis results showed that prepared/planned pregnancy(OR=0.240,95%CI:0.131-0.439,P<0.001),care of relatives during and after confinement(during one month postpartum: OR=0.247,95%CI:0.078-0.782,P=0.017;after one month postpartum: OR=0.350,95%CI:0.192-0.636,P=0.001) could decrease the risk of postpartum depression.Husband and family′s expectations for having a boy(OR=2.948,95%CI:1.882-4.617,P<0.001),mixed feeding for babies within 6 months(OR=2.032,95%CI:1.343-3.076,P=0.001),in favor of breastfeeding but not firmly implemented(OR=1.800,95%CI:1.201-2.697,P=0.004) and baby in poor health(OR=2.815,95%CI:1.724-4.598,P<0.001) could increase the risk of postpartum depression.Conclusion Postpartum depression has a high prevalence in Beijing and is related to many risk factors.Intervention should be strengthened according to relevant risk factors, so as to prevent and reduce the occurrence of postpartum depression.