Webb David A, Bloch Joan R, Coyne James C, Chung Esther K, Bennett Ian M, Culhane Jennifer Flatow
Department of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia, PA 19102, USA.
Birth. 2008 Sep;35(3):179-87. doi: 10.1111/j.1523-536X.2008.00238.x.
Postpartum physical health problems are common and have been understudied. The purpose of this investigation was to explore the associations among reported physical symptoms, functional limitations, and emotional well-being of postpartum women.
The study included data from interviews conducted at 9 to 12 months postpartum from 1,323 women who had received prenatal care at nine community health centers located in Philadelphia, Pennsylvania, United States, between February 2000 and November 2002. Emotional well-being was assessed with the Center for Epidemiological Studies Depression Scale and perceived emotional health. Functional limitations measures were related to child care, daily activities (housework and shopping), and employment. A summary measure of postpartum morbidity burden was constructed from a checklist of potential health problems typically associated with the postpartum period, such as backaches, abdominal pain, and dyspareunia.
More than two-thirds (69%) of the women reported experiencing at least one physical health problem since childbirth. Forty-five percent reported at least one problem of moderate or major (as opposed to minor) severity and 20 percent reported at least one problem of major severity. The presence, severity, and cumulative morbidity burden associated with postpartum health problems were consistently correlated with reports of one or more functional limitations and measures of emotional well-being including depressive symptomatology.
Although physical problems typically associated with the postpartum period are often regarded as transient or comparatively minor, they are strongly related both to women's functional impairment and to poor emotional health. Careful assessment of the physical, functional, and emotional health status of women in the year after childbirth may improve the quality of postpartum care.
产后身体健康问题很常见,但研究较少。本调查的目的是探讨产后女性报告的身体症状、功能受限与情绪健康之间的关联。
该研究纳入了2000年2月至2002年11月期间在美国宾夕法尼亚州费城的九个社区卫生中心接受产前护理的1323名女性产后9至12个月进行访谈的数据。情绪健康通过流行病学研究中心抑郁量表和感知情绪健康进行评估。功能受限测量与儿童护理、日常活动(家务和购物)以及就业有关。产后发病负担的综合测量是根据一份通常与产后时期相关的潜在健康问题清单构建的,如背痛、腹痛和性交困难。
超过三分之二(69%)的女性报告自分娩后至少经历过一种身体健康问题。45%的女性报告至少有一个中度或重度(而非轻度)问题,20%的女性报告至少有一个重度问题。与产后健康问题相关的存在、严重程度和累积发病负担与一种或多种功能受限的报告以及包括抑郁症状在内的情绪健康测量结果始终相关。
尽管通常与产后时期相关的身体问题常被视为短暂的或相对轻微的,但它们与女性的功能损害和不良情绪健康都密切相关。仔细评估产后一年内女性的身体、功能和情绪健康状况可能会提高产后护理质量。