产后抑郁的危险因素及正念减压疗法对产妇认知和EPDS评分的影响

Risk factors of maternal postpartum depression and the effect of mindfulness-based stress reduction intervention on maternal cognition and EPDS score

目的分析产后抑郁的独立危险因素,探讨正念减压疗法对产妇认知功能评分和爱丁堡产后抑郁量表(EPDS)评分的影响。方法选取2019年4月—2021年12月嘉兴市妇幼保健院接诊的124例产后抑郁产妇为研究对象,再选取同期来院分娩的100例健康产妇进行对比。按照随机数字表法将124例产后抑郁产妇分为对照组(62例)和研究组(62例)。对照组采用常规心理健康管理,研究组在此基础上给予正念减压疗法干预。研究产后抑郁患者发病的危险因素。干预前、后采用EPDS评分评估两组产妇的认知功能和抑郁情况。结果logistic多元分析结果显示:年龄>30岁、剖宫产、婚姻不和谐、新生儿不健康、有精神疾病史是产后抑郁发生的危险因素。干预前,对照组和研究组自我认知评分分别为(21.55±7.52)分和(22.85±6.29)分;干预后,对照组和研究组自我认知评分分别为(25.76±3.12)分和(35.65±4.33)分。干预后,对照组和研究组患者的自我认知评分均升高,研究组高于对照组,差异均有统计学意义(均P<0.05)。干预前,对照组和研究组患者的EPDS评分分别为(13.03±1.95)分和(14.13±1.78)分;干预后,对照组和研究组患者的EPDS评分分别为(10.30±1.66)分和(5.63±1.33)分。干预后,对照组和研究组患者的EPDS评分均降低,研究组低于对照组,差异均有统计学意义(均P<0.05)。结论分娩方式、精神疾病史、婚姻和谐程度、年龄、新生儿健康状况是产后抑郁发生的影响因素。采用正念减压疗法对产妇进行心理健康管理,可以提高产妇的认知功能,缓解产妇的抑郁情绪,且正念减压疗法易于产妇理解操作,可以作为产妇抑郁情绪的健康管理干预方法在临床推广应用。

Objective To analyze the independent risk factors of postpartum depression,explore the effects of mindfulness-based stress reduction intervention on maternal cognitive function score and Edingburgh postnatal depression scale(EPDS)score.Methods A total of 124 cases of puerperal depression in Jiaxing Maternal and Child Health Care Hospital from April 2019 to December 2021 were selected as research object,and 100 cases of healthy puerpera who delivered in the hospital during the same period were selected for comparison.The women with postpartum depression were divided into control group(62 cases)and study group(62 cases)using a random number table.The women in control group received routine mental health management,and the women in study group received mindfulness-based stress reduction intervention based on routine mental health management.The risk factors of postpartum depression were researched.Cognitive function and depression score were assessed by EPDS score before and after intervention.Results Logistic multivariate analysis showed that maternal age more than 30 years old,cesarean section,marital disharmony,unhealthy neonate,and history of mental illness were risk factors of postpartum depression.Before intervention,cognitive function scores in control group and study group were(21.55±7.52)and(22.85±6.29),respectively.After intervention,cognitive function scores in control group and study group were(25.76±3.12)and(35.65±4.33),respectively.After intervention,cognitive function scores in control group and study group increased,especially in study group(P<0.05).Before intervention,EPDS scores in control group and study group were(13.03±1.95)and(14.13±1.78),respectively.After intervention,EPDS scores in control group and study group were(10.30±1.66)and(5.63±1.33),respectively.After intervention,EPDS scores in control group and study group decreased,especially in study group(P<0.05).Conclusion Delivery mode,mental illness history,marital harmony,age,and newborn health status are influencing factors of postpartum depression.Using mindfulness-based stress reduction intervention to manage maternal mental health can improve maternal cognitive function and relieve maternal depression,and mindfulness-based stress reduction intervention is easy for maternal women to understand and operate,so it can be used as a health management intervention method for maternal depression in clinical application.