Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong.
Hong Kong Med J. 2021 Apr;27(2):113-117. doi: 10.12809/hkmj208774. Epub 2020 Nov 5.
Owing to the coronavirus disease 2019 outbreak Hong Kong hospitals have suspended visiting periods and made mask wearing mandatory. In obstetrics, companionship during childbirth has been suspended and prenatal exercises, antenatal talks, hospital tours, and postnatal classes have been cancelled. The aim of the present study was to investigate the effects of these restrictive measures on delivery plans and risks of postpartum depression.
We compared pregnancy data and the Edinburgh Postpartum Depression Scale (EPDS) scores of women who delivered between the pre-alert period (1 Jan 2019 to 4 Jan 2020) and post-alert period (5 Jan 2020 to 30 Apr 2020) in a tertiary university public hospital in Hong Kong. Screening for postpartum depression was performed routinely using the EPDS questionnaire 1 day and within 1 week after delivery.
There was a 13.1% reduction in the number of deliveries between 1 January and 30 April from 1144 in 2019 to 994 in 2020. The EPDS scores were available for 4357 out of 4531 deliveries (96.2%). A significantly higher proportion of women had EPDS scores of ≥10 1 day after delivery in the post-alert group than the pre-alert group (14.4% vs 11.9%; P<0.05). More women used pethidine (6.2% vs 4.6%) and fewer used a birthing ball (8.5% vs 12.4%) for pain relief during labour in the post-alert group.
Pregnant women reported more depressive symptoms in the postpartum period following the alert announcement regarding coronavirus infection in Hong Kong. This was coupled with a drop in the delivery rate at our public hospital. Suspension of childbirth companionship might have altered the methods of intrapartum pain relief and the overall pregnancy experience.
由于 2019 年冠状病毒病疫情，香港医院暂停了探访时间，并强制佩戴口罩。在产科，陪产被暂停，产前运动、产前讲座、医院参观和产后课程也被取消。本研究旨在调查这些限制措施对分娩计划和产后抑郁风险的影响。
我们比较了香港一所三级大学公立医院在警戒前（2019 年 1 月 1 日至 1 月 4 日）和警戒后（2020 年 1 月 5 日至 4 月 30 日）期间分娩的孕妇的妊娠数据和爱丁堡产后抑郁量表（EPDS）评分。产后抑郁的筛查常规使用 EPDS 问卷在分娩后 1 天和 1 周内进行。
在 1 月 1 日至 4 月 30 日期间，分娩数量从 2019 年的 1144 例减少到 2020 年的 994 例，降幅为 13.1%。EPDS 评分可获得 4531 次分娩中的 4357 次（96.2%）。警戒后组产后 1 天 EPDS 评分≥10 的妇女比例明显高于警戒前组（14.4%比 11.9%；P<0.05）。警戒后组使用哌替啶（6.2%比 4.6%）缓解分娩疼痛的妇女比例较高，而使用分娩球（8.5%比 12.4%）的妇女比例较低。
在香港宣布冠状病毒感染警戒后，孕妇在产后期间报告的抑郁症状更多。这与我们公立医院的分娩率下降有关。陪产的暂停可能改变了分娩时缓解疼痛的方法和整体妊娠体验。
