埃塞俄比亚巴赫达尔市公共卫生机构产后妇女中儿童期性虐待对心理健康的影响：多中心研究
The Effect of Early Childhood Sexual Abuse on Mental Health Among Postpartum Women Visiting Public Health Facilities in Bahir Dar City, Ethiopia: Multicenter Study.
作者信息
Belete Habte, Misgan Eyaya, Mihret Muhabaw Shumye
机构信息
Psychiatry Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Gynecology and Obstetrics Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
出版信息
Int J Womens Health. 2020 Dec 31;12:1271-1281. doi: 10.2147/IJWH.S283924. eCollection 2020.
BACKGROUND
There is a scarcity of evidence regarding the effects of early childhood sexual abuse on mental health among women in Sub-Saharan Africa. The purpose of this study was to assess the proportion of postpartum depression and associated factors among postnatal women in care in public health facilities of Bahir Dar city, northwest Ethiopia. This study also aimed at evaluating the effect of early childhood sexual abuse on postpartum depression.
METHODS
A multicenter cross-sectional study was conducted among 988 postpartum women in care at Bahir Dar city's public health facilities. A two-stage sampling technique and interviewer administered structured questionnaire were utilized. Edinburgh Postnatal Depression Scale (EPDS) with a cutoff point of ≥ 12 was employed to report postpartum depression. Binary logistic regression model was fitted and the level of significance was reported based on AOR with 95% CI at p-value of < 0.05.
RESULTS
The prevalence of postpartum depression was 33.8% (95% CI: 31, 37) and 55.3% (95% CI: 46, 64) among all study participants and mothers having a history of childhood sexual abuse, respectively. Participants' age of < 25 years (AOR = 3.1; 95% CI: 1.9, 5.3) and 25-34 years (AOR= 2.0; 95% CI: 1.3, 3.2), family size of >5 (AOR = 2.5; 95% CI: 1.1, 5.7), alcohol use (AOR = 2.2; 95% CI: 1.6, 2.9), history of childhood sexual abuse (AOR = 2.8; 95% CI: 1.9, 4.3), joblessness (AOR = 1.4; 95% CI: 1.1, 1.9) and growing up with biological mothers (AOR = 0.5; 95% CI: 0.4, 0.8) have stastical significant association with postpartum depression as compared to the respective reference group.
CONCLUSION
A significantly higher burden of postpartum depression was observed among mothers with a history of childhood sexual abuse. Thus, controlling childhood sexual abuse and other psychosocial determinants would improve maternal mental wellness.
背景
关于撒哈拉以南非洲地区妇女童年期性虐待对心理健康影响的证据匮乏。本研究的目的是评估埃塞俄比亚西北部巴赫达尔市公共卫生设施中产后妇女产后抑郁症的比例及相关因素。本研究还旨在评估童年期性虐待对产后抑郁症的影响。
方法
对巴赫达尔市公共卫生设施中988名产后妇女进行了一项多中心横断面研究。采用两阶段抽样技术和由访谈员实施的结构化问卷。采用爱丁堡产后抑郁量表（EPDS），以≥12分为临界值来报告产后抑郁症。拟合二元逻辑回归模型，并根据比值比（AOR）及95%置信区间（CI）在p值<0.05时报告显著性水平。
结果
在所有研究参与者和有童年期性虐待史的母亲中，产后抑郁症的患病率分别为33.8%（95%CI：31，37）和55.3%（95%CI：46，64）。与各自的参照组相比，年龄<25岁（AOR = 3.1；95%CI：1.9，5.3）和25 - 34岁（AOR = 2.0；95%CI：1.3，3.2）的参与者、家庭规模>5（AOR = 2.5；95%CI：1.1，5.7）、饮酒（AOR = 2.2；95%CI：1.6，2.9）、童年期性虐待史（AOR = 2.8；95%CI：1.9，4.3）、失业（AOR = 1.4；95%CI：1.1，1.9）以及与亲生母亲一起长大（AOR = 0.5；95%CI：0.4，0.8）与产后抑郁症有统计学显著关联。
结论
有童年期性虐待史的母亲中产后抑郁症负担明显更高。因此，控制童年期性虐待及其他社会心理决定因素将改善孕产妇心理健康。
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