Judith Lumley Centre, La Trobe University, Level 3 George Singer Building, Bundoora, Melbourne, VIC, 3086, Australia.
Jean Hailes Research Unit, Melbourne, Australia.
Arch Womens Ment Health. 2018 Jun;21(3):365-374. doi: 10.1007/s00737-017-0805-y. Epub 2017 Dec 20.
This study aimed to investigate prospectively the contribution of maternal physical health and/or breastfeeding problems to maternal mood (depression, anxiety, fatigue, irritability, confusion, vigor) at 8-weeks postpartum. A prospective study was conducted. Participants were recruited antenatally from a public and a private maternity hospital in Melbourne, Australia. Nulliparous pregnant women (N = 229), ≥ 18 years of age, ≥ 36-week gestation, singleton pregnancy and with sufficient English were eligible. Data were collected by self-report questionnaire (pregnancy, weeks 1-4 postpartum) and telephone interview (week 8 postpartum). A high burden of physical problems was classified as ≥ 3 problems (caesarean/perineal pain; back pain; constipation; haemorrhoids; urinary and bowel incontinence) for ≥ 2 time points. A high burden of breastfeeding problems was having ≥ 2 problems (mastitis; nipple pain; frequent expressing; over- or under-supply of milk) for ≥ 2 time points. Multivariate linear regression was used to investigate the relationship between maternal mood, assessed using Profile of Mood States (8-week postpartum), and a high burden of breastfeeding and/or physical health problems. Forty-six women (20.1%) had a high burden of physical symptoms, 44 (19.2%) a high burden of breastfeeding problems only and 25 women (11.0%) had both. A high burden of breastfeeding problems alone (β = 10.6, p = 0.01) or with co-morbid physical problems (β = 15.35, p = 0.002) was significantly associated with poorer maternal mood at 8 weeks. Early, effective postnatal treatment of maternal health and breastfeeding problems could reduce women's risk for poor mental health.
本研究旨在前瞻性地探讨产妇身体健康和/或母乳喂养问题对产后 8 周时产妇情绪（抑郁、焦虑、疲劳、易怒、困惑、活力）的影响。采用前瞻性研究。参与者在澳大利亚墨尔本的一家公立和一家私立妇产医院产前招募。合格的参与者为初产妇（N=229），年龄≥18 岁，≥36 周妊娠，单胎妊娠，英语水平足够。数据通过自我报告问卷（妊娠，产后第 1-4 周）和电话访谈（产后第 8 周）收集。身体问题负担高被定义为≥3 个问题（剖宫产/会阴疼痛；背痛；便秘；痔疮；尿失禁和肠失禁）至少 2 个时间点出现，≥2 个问题（乳腺炎；乳头疼痛；频繁挤奶；乳汁过多或过少）至少 2 个时间点出现。多变量线性回归用于调查产后 8 周时使用状态-特质焦虑问卷（Profile of Mood States）评估的产妇情绪与母乳喂养和/或身体健康问题高负担之间的关系。46 名女性（20.1%）有身体症状高负担，44 名（19.2%）仅有母乳喂养问题高负担，25 名女性（11.0%）同时存在这两种问题。单独的母乳喂养问题高负担（β=10.6，p=0.01）或伴有合并身体问题（β=15.35，p=0.002）与产后 8 周时产妇情绪较差显著相关。早期、有效的产后母婴健康和母乳喂养问题治疗可以降低女性心理健康不良的风险。
