Ilter Bahadur Evin, Asena Muhammed, Yavuz Yılmaz, Karabulut Erdem, Ozmert Elif Nursel
Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Pediatrics, Gaziyaşargil Education and Research Hospital, University of Health Science, Diyarbakir, Turkey.
J Obstet Gynaecol Res. 2021 Dec;47(12):4289-4297. doi: 10.1111/jog.15049. Epub 2021 Oct 4.
Improved knowledge of causal and protective factors is crucial for Postpartum depression (PPD) prevention and management.
To investigate the relationship between adverse childhood experience (ACE), perceived social support and PPD in a middle-income non-Western country, and to investigate which type of ACE and which sources of social support were associated with PPD.
The study was cross-sectional study and conducted in a one center from Turkey during March-June 2019. Women up to 1-week postpartum were included in the study. The Edinburgh Postpartum Depression Scale (EPDS), a validated ACE questionnaire, and the Multidimensional Scale of Perceived Social Support were completed.
Nine hundred women took part in the study. The proportion identified with PPD and ACE were 10% and 8.8%, respectively. In bivariate analysis, having previous PPD, unwanted pregnancy, insufficient antenatal care, low family income, history of ACE, and perception of low social support were associated with PPD (p < 0.05). Family support was perceived as beneficial, in both women with no history or ≥2 instances of ACE. However, perceived support from friends and/or a special person was lowest in the ≥2 ACE group (p < 0.05). In logistic regression, unwanted pregnancy, emotional abuse, and neglect, incarceration of a household member, and poor special person support were factors significantly associated with developing PPD (p = 0.005).
Emotional abuse, neglect, household dysfunction, and perceived poor support from a special person were risk factors for PPD. A history of maternal childhood trauma and poor social support might indicate the need for early PPD interventions.
深入了解产后抑郁症(PPD)的因果及保护因素对于其预防和管理至关重要。
在一个非西方中等收入国家,调查童年不良经历(ACE)、感知到的社会支持与PPD之间的关系,并探究哪种类型的ACE以及哪些社会支持来源与PPD相关。
本研究为横断面研究,于2019年3月至6月在土耳其的一个中心开展。纳入产后1周内的女性。完成爱丁堡产后抑郁量表(EPDS)、一份经过验证的ACE问卷以及多维感知社会支持量表。
900名女性参与了本研究。被确诊为PPD和ACE的比例分别为10%和8.8%。在双变量分析中,既往有PPD、意外怀孕、产前护理不足、家庭收入低、ACE病史以及感知到的社会支持低与PPD相关(p < 0.05)。在无ACE病史或ACE≥2次的女性中,家庭支持都被视为有益。然而,在ACE≥2次的组中,来自朋友和/或特殊人物的感知支持最低(p < 0.05)。在逻辑回归中,意外怀孕、情感虐待和忽视、家庭成员被监禁以及特殊人物支持差是与发生PPD显著相关的因素(p = 0.005)。
情感虐待、忽视、家庭功能障碍以及来自特殊人物的感知支持差是PPD的危险因素。母亲童年创伤史和社会支持差可能表明需要早期进行PPD干预。