Department of Dietetics, Nanfang Hospital, Southern Medical University, 1838 N. Guangzhou Avenue, Guangzhou, 510515, China.
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 N. Guangzhou Avenue, Guangzhou, 510515, China.
BMC Pregnancy Childbirth. 2020 Apr 16;20(1):226. doi: 10.1186/s12884-020-02906-y.
Postpartum depression (PPD) is prevalent and may present major adverse impacts on mother and child health. According to previous studies, mostly from the western society, PPD may have complicated etiologies, such as genetic, social and psychological factors. The aim of this study was to explore the associations of some social and clinical factors, particularly those unique in Chinese, with significant PPD symptoms.
A sample of 556 pregnant women in their 36th to 40th gestational week were randomly recruited in a cross-sectional study using a self-reported questionnaire, which collected maternal sociodemographic and clinical information. During their 2nd to 4th postpartum months, 522 participants responded to our screening of significant PPD symptoms, based on a score of Edinburgh Postnatal Depression Scale ≥9.
A total of 90 (17.3%) participants were identified with significant PPD symptoms, and the following factors were observed more frequently in women with significant PPD symptoms (PPD) than with fewer symptoms (PPD): intensive involvement of parents-in-law in a participant's life (living together with her, taking care of her, or discriminating against a female baby), lack of support from husband, cesarean delivery, and breast milk insufficiency (supplemented with formula). After multiple logistic regression analysis, parents-in-law's preference to baby boy while devaluing baby girl, dissatisfaction with husband's support, cesarean delivery, and mixed feeding were strongly associated with significant PPD symptoms.
The potential risk factors for significant PPD symptoms, i.e., "son preference" custom, cesarean delivery and mixed feeding, deserve confirmation in continued, especially clinical diagnosis-based longitudinal studies.
产后抑郁症(PPD)普遍存在,可能对母婴健康造成重大不良影响。根据以往研究,主要来自西方社会,PPD 可能具有复杂的病因,如遗传、社会和心理因素。本研究旨在探讨一些社会和临床因素与产后抑郁症的关联,特别是在中国特有的因素与产后抑郁症的关联。
采用横断面研究,随机招募 556 名处于妊娠 36 周到 40 周的孕妇,使用自我报告问卷收集产妇社会人口学和临床信息。在产后第 2 至 4 个月期间,522 名参与者根据爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale)评分≥9 分进行了产后抑郁症严重程度的筛查。
共有 90 名(17.3%)参与者被确定为产后抑郁症症状明显,与产后抑郁症症状较轻的参与者相比,以下因素在产后抑郁症症状明显的参与者中更为常见(PPD):公婆过度参与参与者的生活(与她同住、照顾她或歧视女婴)、缺乏丈夫的支持、剖宫产和母乳不足(补充配方奶)。经多因素逻辑回归分析,公婆偏爱男婴而轻视女婴、对丈夫支持不满、剖宫产和混合喂养与产后抑郁症症状明显强烈相关。
需要在持续的研究中,特别是基于临床诊断的纵向研究中,进一步证实产后抑郁症症状的潜在危险因素,即“男孩偏好”习俗、剖宫产和混合喂养。