Zelkowitz P, Saucier J-F, Wang T, Katofsky L, Valenzuela M, Westreich R
Department of Psychiatry, Sir Mortimer Davis Jewish General Hospital, McGill University, Montréal, Québec, Canada.
Arch Womens Ment Health. 2008;11(1):1-11. doi: 10.1007/s00737-008-0219-y. Epub 2008 Feb 14.
The present study explored changes in mental health and functional status from pregnancy to 2 months postpartum in a sample of 106 childbearing immigrant women. Three sets of variables were examined in relation to postpartum depressive symptomatology: (1) prenatal depression, worries, and somatic symptoms; (2) social relationships (marital quality and social support), and (3) factors related to migration (premigration stress and length of stay in the host country). We found that 37.7% of the women in this community sample scored above the cutpoint of 12 on the Edinburgh Postnatal Depression Scale; prenatal depressive and somatic symptoms, as well as marital quality, were the best predictors of postpartum depressive symptomatology. An examination of differing trajectories from pregnancy to the postpartum period suggests that women with relatively few somatic complaints, low levels of perinatal stress, and satisfactory marital relations were less likely to exhibit mental health problems during pregnancy and postpartum. Women who were not depressed prenatally but reported postpartum depressive symptomatology exhibited several predisposing risk factors during pregnancy: many somatic complaints, high perinatal anxiety, and premigration stress. Women who were depressed during pregnancy but not postpartum reported improved physical function after childbirth. The implications of these findings for screening childbearing immigrant women are discussed.
本研究探讨了106名育龄移民妇女从怀孕到产后2个月期间心理健康和功能状态的变化。针对产后抑郁症状,研究了三组变量:(1)产前抑郁、担忧和躯体症状;(2)社会关系(婚姻质量和社会支持),以及(3)与移民相关的因素(移民前压力和在东道国的停留时间)。我们发现,在这个社区样本中,37.7%的女性在爱丁堡产后抑郁量表上的得分高于12分的临界值;产前抑郁和躯体症状以及婚姻质量是产后抑郁症状的最佳预测因素。对从怀孕到产后不同轨迹的研究表明,躯体不适相对较少、围产期压力水平较低且婚姻关系令人满意的女性在孕期和产后出现心理健康问题的可能性较小。产前未抑郁但报告有产后抑郁症状的女性在孕期表现出一些易感风险因素:许多躯体不适症状高围产期焦虑和移民前压力。孕期抑郁但产后未抑郁的女性在分娩后身体功能有所改善。讨论了这些发现对筛查育龄移民妇女的意义。