Zhang B D, Shan Y C, Xu L W, Chen H, Zhang X N, Tong C Y, Mao Y L, Zhou C
Medical School, Hangzhou Normal University, Hangzhou 310036, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Aug 6;51(8):740-745. doi: 10.3760/cma.j.issn.0253-9624.2017.08.015.
To investigate the situation of social support (SS), and explore its relationship with antenatal depression (AD) among Zhejiang primiparas in their third trimesters. From March to August 2016, a cross-sectional study was conducted and the questionnaire was used at the outpatient consulting room of one maternity hospital in Hangzhou. Inclusion criteria includes the primiparas over 18 years old, gestation from 30 to 36 weeks, been able to understand and complete the questionnaires independently, no family history and history of mental disorders and no use of psychotropic drugs, without serious illness and so on. Exclusion criteria was that the primiparas were unable to complete all the contents of the questionnaire and of poor compliance. 1 150 questionnaires were actually given out, and 1 075 questionnaires were valid, so the valid rate was 93.48%. AD was evaluated by the Edinburgh Postnatal Depression Scale (EPDS) and SS was evaluated by the Perceived Social Support Scale (PSSS). SS between the non-AD group and the AD group was compared. The correlation between SS and AD was analyzed. Binary logistic regression model was used to assess the relationship between SS and AD. The level of SS was divided by average scores, groups lower than the average score was defined as the low-score group, groups higher than the average score was defined as the high-score group. The prevalence of AD (score≥9) was 27.3% (293/1 075) among Zhejiang primiparas in their third trimesters. The scores of family support, friend support and other support, and the total score of SS among the non-AD group were 24.80±2.83, 23.40±3.00, 21.91±3.54 and 70.11±7.92, respectively, which were higher than those in the AD group (22.71±3.88, 21.45±3.59, 19.95±3.97, 64.10±10.01), ( values were 8.43, 8.29, 7.83 and 9.25, respectively, 0.001 for all). The scores of family support, friend support and other support, and the total score of SS were negatively correlated with AD ( values were-0.26,-0.25,-0.22 and-0.28, respectively, 0.001 for all). Compared with low-score group, the scores of family support, friend support and other support, and the total score of SS among the high-score group had a lower risk of antenata depression among primiparas in their third trimesters, (95%) values were 0.56 (0.41-0.77), 0.66(0.47-0.92), 0.57(0.41-0.79) and 0.36(0.27-0.48), respectively. The prevalence of AD among Zhejiang primiparas was relatively high, and AD was negatively associated with SS level. We suggest adding SS in community pregnancy health management service in the future.
调查浙江省孕晚期初产妇的社会支持状况,并探讨其与产前抑郁的关系。2016年3月至8月,在杭州某妇产医院门诊咨询室进行了一项横断面研究,并使用了问卷调查。纳入标准包括年龄超过18岁的初产妇、孕周为30至36周、能够独立理解并完成问卷、无精神疾病家族史和病史且未使用精神类药物、无严重疾病等。排除标准是初产妇无法完成问卷所有内容且依从性差。实际发放问卷1150份,有效问卷1075份,有效率为93.48%。采用爱丁堡产后抑郁量表(EPDS)评估产前抑郁,采用领悟社会支持量表(PSSS)评估社会支持。比较非产前抑郁组和产前抑郁组的社会支持情况。分析社会支持与产前抑郁的相关性。采用二元logistic回归模型评估社会支持与产前抑郁的关系。社会支持水平以平均分划分,低于平均分的组定义为低分组合高于平均分的组定义为高分组合。浙江省孕晚期初产妇中产前抑郁(得分≥9)的患病率为27.3%(293/1075)。非产前抑郁组的家庭支持、朋友支持和其他支持得分以及社会支持总分分别为24.80±2.83、23.40±3.00、21.91±3.54和70.11±7.92,均高于产前抑郁组(22.71±3.88、21.45±3.59、19.95±3.97、64.10±10.01),(值分别为8.43、8.29、7.83和9.25,均P<0.001)。家庭支持、朋友支持和其他支持得分以及社会支持总分与产前抑郁呈负相关(值分别为-0.26、-0.25、-0.22和-0.28,均P<0.001)。与低分组合相比,高分组合的家庭支持、朋友支持和其他支持得分以及社会支持总分在孕晚期初产妇中发生产前抑郁的风险较低,(95%)值分别为0.56(0.41-0.77)、0.66(0.47-0.92)、0.57(0.41-0.79)和0.36(0.27-0.48)。浙江省初产妇产前抑郁患病率较高,且产前抑郁与社会支持水平呈负相关。建议未来在社区孕期健康管理服务中增加社会支持内容。