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[哈尔滨市高危妊娠妇女产后抑郁状况及相关社会心理因素研究]

[Study on the status and related socio-psychological factors of maternal depression among high-risk pregnancy women in Harbin city].

作者信息

Xie Ya-chun, Yuan Hong-wei, Zhuang Ru-jin, Han Cong-hui, Liu Shu-hong, Chen Su-fen, Fu Zhi-wei, Wang Zhi-ming, Qiao Su-zhen, Guo Lin, Zhang Hui-ying

机构信息

Department of Child and Adolescent Health and Maternal Health Care, Public Health School, Harbin Medical University, Harbin 150086, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2012 Jun;46(6):543-6.

Abstract

OBJECTIVE

This study aimed to investigate the depression status among high-risk pregnancy women, and to analyze its relevant social and psychological factors.

METHODS

A total of 42 high-risk pregnancy women and 40 normal pregnancy women in a teaching hospital in Harbin city were followed up at time points of 32 - 36 weeks pregnancy, one week before labor, one week postpartum, and six weeks postpartum, respectively. During follow-up, the basic situation, social psychosocial factors of pregnancy women were collected and the depression of pregnancy women was measured by self-designed questionnaire and self-rating depression scale. The Edinburgh Postnatal Depression Scale (EPDS) was applied at timepoint of one week postpartum. Single factor analysis and the unconditional multivariate logistic regression were applied for analyzing the on the related social-psychosocial factors among high-risk pregnancy women.

RESULTS

The age of high-risk pregnancy women was (31.0±5.6), and the age of normal pregnancy women was (30.5±3.8) (t=0.169, P>0.05). The results showed that the depression rate in high-risk pregnancy women was 45.2% (19/42), which was 25.0% (10/40) in normal pregnancy women, the difference was significant (χ2=3.671, P=0.045). The depression rates at different time points were 30.9% (13/42), 42.9% (18/42), 23.8% (10/42), 26.2% (11/42) in high-risk pregnancy women respectively, and 25.0% (10/40), 15.0% (6/40), 20.0% (8/40), 17.5% (7/40) in the control group respectively, the difference of the depression rates among groups at one week before labor was significant (χ2=7.680, P<0.01), the difference among groups at 32-36 weeks pregnancy (χ2=0.133, P=0.80), at one week postpartum (χ2=0.174, P=0.79) and at six weeks postpartum (χ2=0.903, P=0.43) were not significant. At one week postpartum and six weeks postpartum periods, the EPDS depression rate were 12.5% (4/32), 30.4% (7/23) in case group respectively, 8.3% (3/36), 22.9% (8/35) in control group respectively, the difference were not significant (χ2=0.319, 0.416, P=0.573, 0.519). There were significantly associations between the depression mood of one week before labor and the depressive symptoms of six weeks postpartum in both groups (r=0.824, 0.677, both P values were <0.05). The risk factors for maternal depression among high-risk pregnancy women were not ready for production (OR=2.73, P<0.01) and fearing of childbirth safety (OR=2.89, P<0.01).

CONCLUSION

The depression date of high-risk pregnancy was high, especially at the time point one week before labor. Risk factors of maternal depression among high-risk pregnancy were "not ready for production" and "fear of childbirth safety".

摘要

目的

本研究旨在调查高危妊娠妇女的抑郁状况,并分析其相关的社会和心理因素。

方法

选取哈尔滨市某教学医院的42例高危妊娠妇女和40例正常妊娠妇女,分别在妊娠32 - 36周、临产前1周、产后1周和产后6周进行随访。随访期间,收集孕妇的基本情况、社会心理因素,采用自行设计的问卷和自评抑郁量表对孕妇的抑郁情况进行测评。在产后1周时间点应用爱丁堡产后抑郁量表(EPDS)。采用单因素分析和非条件多因素logistic回归分析高危妊娠妇女相关的社会心理因素。

结果

高危妊娠妇女年龄为(31.0±5.6)岁,正常妊娠妇女年龄为(30.5±3.8)岁(t = 0.169,P>0.05)。结果显示,高危妊娠妇女抑郁发生率为45.2%(19/42),正常妊娠妇女为25.0%(10/40),差异有统计学意义(χ2 = 3.671,P = 0.045)。高危妊娠妇女在不同时间点的抑郁发生率分别为30.9%(13/42)、42.9%(18/42)、23.8%(10/42)、26.2%(11/42),对照组分别为25.0%(10/40)、15.0%(6/40)、20.0%(8/40)、17.5%(7/40),临产前1周两组抑郁发生率差异有统计学意义(χ2 = 7.680,P<0.01),妊娠32 - 36周(χ2 = 0.133,P = 0.80)、产后1周(χ2 = 0.174,P = 0.79)和产后6周(χ2 = 0.903,P = 0.43)两组差异无统计学意义。产后1周和产后6周时,病例组EPDS抑郁发生率分别为12.5%(4/32)、30.4%(7/23),对照组分别为8.3%(3/36)、22.9%(8/35),差异无统计学意义(χ2 = 0.319,0.416,P = 0.573,0.519)。两组临产前1周的抑郁情绪与产后6周的抑郁症状均存在显著相关性(r = 0.824,0.677,P值均<0.05)。高危妊娠妇女发生抑郁的危险因素为未做好生产准备(OR = 2.73,P<0.01)和担心分娩安全(OR = 2.89,P<0.01)。

结论

高危妊娠妇女抑郁发生率较高,尤其是临产前1周时间点。高危妊娠妇女发生抑郁的危险因素为“未做好生产准备”和“担心分娩安全”。

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