Discipline of Occupational Therapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
S Afr Med J. 2022 Jul 1;112(7):494-501.
Maternal mental health during the perinatal period has been of interest to many researchers, with antenatal depression and postnatal depression (PND) being a leading cause of morbidity. The adverse effects of maternal depression on the offspring throughout infancy, childhood and adolescence are well documented. Studies on the mental health of persons living with HIV have also reported a high prevalence of depression.
To describe the prevalence of PND in a sample of HIV-positive and HIV-negative mothers delivering healthy singleton infants at one obstetric unit in KwaZulu-Natal (KZN) Province, South Africa, and the subsequent factors influencing neonatal behaviour and perceptions of caregiver competence. Correlations between the presence of PND and perceptions of caregiver competence (with the mother as caregiver), and between infant behaviour, the mother's confidence in her competence as caregiver, and demographic and medical variables, were also examined.
Demographic and clinical data were collected from 132 mothers at initial contact and from 32 mothers at the 6-week follow-up appointment. Mothers independently completed the Edinburgh Postnatal Depression Scale at each time point, and the Mother and Baby Scales (MABS) at the 6-week follow-up appointment.
The prevalence of depression among all mothers at initial contact was 72.0%, remaining high (68.8%) among the mothers who returned for follow-up. There was a statistically significant correlation between depression and employment at follow-up (p=0.013), and between depression and delivery method (p=0.030). The majority of mothers reported being 'able to laugh and see the funny side of things' and 'looking forward with enjoyment to things' at initial contact and follow-up. Thoughts of self-harm were reported by 44.7% of mothers at baseline, and by 53.1% at follow-up. Although most infants scored in the average clinical band for neonatal behavioural factors in the MABS, mothers reported lack of confidence, globally and in caring for their infant.
This study of maternal mental health of a sample of HIV-positive and HIV-negative mothers of infants in KZN revealed a higher prevalence of PND than reported in other studies. This population of mothers and infants is at risk of adverse outcomes of maternal depression, in addition to other possible risk factors.
围产期产妇的心理健康一直是许多研究人员关注的焦点，产前抑郁症和产后抑郁症（PND）是发病率的主要原因。产妇抑郁对婴儿在婴儿期、儿童期和青春期的不良影响有充分的记录。对感染艾滋病毒的人的心理健康的研究也报告了抑郁症的高发病率。
描述在南非夸祖鲁-纳塔尔省（KZN）的一个产科单位分娩健康单胎婴儿的 HIV 阳性和 HIV 阴性母亲样本中 PND 的流行情况，以及随后影响新生儿行为和照顾者能力感知的因素。还检查了 PND 的存在与照顾者能力感知（以母亲为照顾者）之间的相关性，以及婴儿行为、母亲对自己作为照顾者的能力的信心与人口统计学和医学变量之间的相关性。
在初次接触时从 132 名母亲和在 6 周随访预约时从 32 名母亲收集人口统计学和临床数据。母亲在每个时间点都独立完成爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale），并在 6 周随访预约时完成母亲和婴儿量表（Mother and Baby Scales，MABS）。
所有母亲在初次接触时的抑郁患病率为 72.0%，在返回随访的母亲中仍保持较高（68.8%）。抑郁与随访时的就业情况呈统计学显著相关（p=0.013），与分娩方式呈统计学显著相关（p=0.030）。大多数母亲在初次接触和随访时报告“能够笑并看到事情有趣的一面”和“期待事情的乐趣”。有 44.7%的母亲在基线时报告有自残念头，53.1%的母亲在随访时报告有自残念头。尽管大多数婴儿在 MABS 的新生儿行为因素的平均临床波段中得分，但母亲报告对自己和照顾婴儿缺乏信心。
本研究对 KZN 的 HIV 阳性和 HIV 阴性母亲的母婴样本的产妇心理健康进行了研究，发现 PND 的患病率高于其他研究报告。这一母亲和婴儿群体除了其他可能的风险因素外，还面临着产妇抑郁的不良后果的风险。
