Hayes B A, Muller R, Bradley B S
Nursing, James Cook University, Townsville, Queensland, Australia.
Birth. 2001 Mar;28(1):28-35. doi: 10.1046/j.1523-536x.2001.00028.x.
Depression can be an unexpected and distressing companion for a woman during the major life transition of becoming a mother for the first time. Researchers now demonstrate that approximately 50 percent of women will experience perinatal distress. Therefore, the etiology and management of perinatal depression is essential for a quality care of childbearing women. The objectives of this study were to develop an education intervention tailored to the information needs of primiparous women about perinatal depression, to deliver this intervention antenatally, and to conduct a randomized controlled trial to determine the effect of the antenatal education intervention in the reduction of postnatal depression.
A prospective, randomized controlled trial of the education intervention (n = 206) was conducted at three sites in Australia. The outcome of changes in mood state was measured by the Profile of Mood States questionnaire once antenatally (12-28 wk), and twice postnatally (8-12 and 16-24 wk); social support and demographic data were also collected. The education package was administered to the intervention group at the antenatal assessment of mood.
A significant and steady reduction in scores (overall and on the subscales) was observed over time for both groups that showed significant improvement in symptoms of depression. No difference was detected when comparing the intervention group with the control group. Additional multivariate regression analyses revealed no relevant influence of social support or demographic variables.
Women in both the study and control groups were more depressed antenatally than postnatally. The finding that the education intervention made no difference challenges the two strongly held tenets of health education in childbearing women-that depression can be reduced through education and that antenatal education interventions can endure into the postnatal period.
在首次成为母亲这一重大人生转变过程中，抑郁症可能会意外出现并困扰女性。研究人员现已证明，约50%的女性会经历围产期困扰。因此，围产期抑郁症的病因及管理对于为育龄妇女提供优质护理至关重要。本研究的目的是针对初产妇对围产期抑郁症的信息需求制定一项教育干预措施，在产前实施该干预措施，并进行一项随机对照试验，以确定产前教育干预对降低产后抑郁症的效果。
在澳大利亚的三个地点对教育干预措施（n = 206）进行了一项前瞻性随机对照试验。情绪状态变化的结果通过情绪状态剖面图问卷进行测量，产前测量一次（12 - 28周），产后测量两次（8 - 12周和16 - 24周）；还收集了社会支持和人口统计学数据。在产前情绪评估时对干预组实施教育包。
随着时间的推移，两组的分数（总分及各子量表分数）均显著且稳步下降，抑郁症症状有显著改善。将干预组与对照组进行比较时未发现差异。额外的多元回归分析显示社会支持或人口统计学变量没有相关影响。
研究组和对照组的女性产前比产后更抑郁。教育干预没有效果这一发现对育龄妇女健康教育的两个坚定信条提出了挑战，即抑郁症可以通过教育减轻，且产前教育干预可以持续到产后阶段。
