Iwata Hiroko, Mori Emi, Tsuchiya Miyako, Sakajo Akiko, Maehara Kunie, Ozawa Harumi, Morita Akiko, Maekawa Tomoko, Aoki Kyoko, Makaya Miyuki, Tamakoshi Koji
Graduate School of Nursing, Chiba University, Chiba, Japan.
Former Graduate School of Nursing, Chiba University, Chiba, Japan.
Jpn J Nurs Sci. 2015 Oct;12(4):297-308. doi: 10.1111/jjns.12069. Epub 2015 Feb 26.
The number of older primiparas is increasing in Japan. These women have been shown to be more vulnerable to post-partum depression. This study aimed to identify factors for predicting post-partum depressive symptoms during hospitalization after childbirth in Japanese primiparas aged 35 years and over.
The present authors used the data of 479 primiparas aged 35 years and over from a prospective cohort study. Data were collected using self-report questionnaires on the day before hospital discharge. The questionnaire consisted of: demographics and background information; depressive symptoms; fatigue; maternal confidence and maternal satisfaction; child-care values; physical symptoms; perceptions of daily life during hospitalization; concerns about child care and daily life; and infant feeding. Additionally, vital records data were obtained from the hospitals. A stepwise logistic regression analysis was performed on the binary outcome variable of depressive symptoms, measured by the Japanese version of the Edinburgh Postnatal Depression Scale. Women who scored 9 or more were considered to be at high risk for post-partum depression. The authors obtained informed consent from all participants and institutional ethics approvals before initiating the study.
The following six variables reliably predicted the risk of post-partum depression: emergency cesarean section, lower satisfaction with birth experience, higher physical burden in daily life, long-term complications with the newborn, more concerns about newborn caretaking after discharge, and more concerns about one's own life after discharge.
Recognition of women with these factors will help nurses to identify those at risk for developing post-partum depression and to provide appropriate care during hospitalization after childbirth.
在日本，高龄初产妇的数量正在增加。这些女性已被证明更容易患产后抑郁症。本研究旨在确定预测35岁及以上日本初产妇产后住院期间抑郁症状的因素。
作者使用了一项前瞻性队列研究中479名35岁及以上初产妇的数据。在出院前一天通过自我报告问卷收集数据。问卷包括：人口统计学和背景信息；抑郁症状；疲劳；母亲信心和母亲满意度；育儿价值观；身体症状；住院期间对日常生活的认知；对育儿和日常生活的担忧；以及婴儿喂养情况。此外，从医院获取了生命记录数据。对由日本版爱丁堡产后抑郁量表测量的抑郁症状二元结局变量进行逐步逻辑回归分析。得分9分及以上的女性被认为有产后抑郁症的高风险。作者在研究开始前获得了所有参与者的知情同意和机构伦理批准。
以下六个变量可靠地预测了产后抑郁症的风险：急诊剖宫产、对分娩经历的满意度较低、日常生活中的身体负担较重、新生儿的长期并发症、出院后对新生儿护理的更多担忧以及出院后对自己生活的更多担忧。
识别有这些因素的女性将有助于护士识别有产后抑郁症风险的人，并在产后住院期间提供适当的护理。
