新产程标准下产后抑郁倾向的影响因素

Influencing factors of liability to postpartum depression following the new criteria of labor stages

目的:分析实施新产程标准后产后抑郁倾向的影响因素。方法:将阴道分娩的单胎初产妇185例根据第二产程时长分为研究组(>2 h但≤3 h)和对照组(≤2 h),采用视觉模拟评分(VAS)评价疼痛感受;产后42 d调查母乳喂养和产后情况,采用Edinburgh产后抑郁量表(EPDS)评估抑郁状态。结果:研究组VAS评分、分娩方式及新生儿性别是否符合意愿、母乳喂养情况、EPDS评分与对照组间无显著差异。回归分析显示EPDS评分影响因素为分娩方式是否符合意愿(B=2.55,P<0.05)、混合喂养(B=1.37,P<0.05)和总产程时长(B=0.16,P<0.05)。结论:产程时长延长增加了产后抑郁风险。对第二产程超过2 h、分娩方式不符期望、母乳喂养意愿强烈但结果不符预期的产妇应加强心理健康关注度,预防产后抑郁发生。

Objective:To investigate the influencing factors of liability to postpartum depression following the new criteria of labor stages.Methods:A total of 185 cases of single⁃pregnancy primiparas were di⁃vided into research group and control group according to the length of the second labor stage.Visual analogue scale(VAS)was scored;42 days later the situation of breastfeeding and Edinburgh postnatal depression scale(EPDS)scores were collected.Results:No significant difference was found in VAS scores,satisfaction with delivery mode and gender,feeding mode,and EPDS scores.The impact fac⁃tors of EPDS scores were satisfaction with delivery mode(B=2.55,P<0.05),mixed feeding(B=1.37,P<0.05),and the length of the total labor stage(B=0.16,P<0.05).Conclusion:The risk of PPD would increase with prolonged labor stages.Attention should be paid to the moods of mothers with a second labor stage more than 2 hours or with a mismatch between birth expectations and experi⁃ences,and mothers failing in pure breastfeeding despite a strong desire.