Boudiaf Lina, Dupont Françoise, Gras-Le Guen Christèle, Sauvaget Anne, Leroy Maxime, Thubert Thibault, Winer Norbert, Dochez Vincent
Service de Gynécologie-Obstétrique, CHU de Nantes, CEDEX, 44093 Nantes, France.
Service de Pédopsychiatrie, CHU de Nantes, CEDEX, 44093 Nantes, France.
J Clin Med. 2022 Sep 20;11(19):5504. doi: 10.3390/jcm11195504.
Background: The COVID-19 pandemic has shaken the world by imposing unprecedented health measures, including in the postpartum period. Objectives: We aim to assess the impact of maternal isolation in the immediate postpartum period on the rate of postpartum depression (PPD) in a tertiary center. Study Design: We conducted a prospective cohort study, between 22 April and 29 October 2020, using anonymous questionnaires on 265 participants (129 during lockdown and 135 outside). The Edinburgh Postnatal Depression Scale (EPDS) was used as screening for PPD. We used a univariate logistic regression model to analyze the association between risk factors and PPD. Results: There was no difference between the two groups for PPD assessed by an EPDS score >10.5 on day 30 and/or day 60 (23.1% vs. 29.3%, p = 0.661) but on day 3 it was higher (31% vs. 17.8%, p = 0.015) during the lockdown period and partners were more impacted psychologically (48.3% vs. 10.5%, p < 0.001). Parity ≥1 was a protective factor for PPD (OR = 0.2, 95% CI [0.1−0.6], p = 0.003). Risk factors of PPD were: history of psychological abuses (OR = 6.4, CI 95% [1.1−37.6], p = 0.04), stressful life event (OR = 4.5, CI 95% [1.6−12.6], p = 0.004), and bad birth experience (OR = 5.1, CI 95% [1.4−17.8], p = 0.012). Conclusion: Maternal isolation in the immediate postpartum period is associated with an increased rate of moderate to severe symptoms of postpartum blues. The well-known long-term consequences of PPD must be balanced against the expected benefits of partner’s restrictive access to maternity ward.
新冠疫情通过实施前所未有的卫生措施给世界带来了震动，产后阶段亦是如此。目的：我们旨在评估三级医疗中心产后即刻产妇隔离对产后抑郁症（PPD）发生率的影响。研究设计：我们于2020年4月22日至10月29日开展了一项前瞻性队列研究，使用匿名问卷对265名参与者进行调查（封锁期间129名，封锁期外135名）。爱丁堡产后抑郁量表（EPDS）用于筛查PPD。我们使用单因素逻辑回归模型分析风险因素与PPD之间的关联。结果：两组在产后第30天和/或第60天通过EPDS评分>10.5评估的PPD情况无差异（23.1%对29.3%，p = 0.661），但在产后第3天，封锁期间的PPD发生率更高（31%对17.8%，p = 0.015），且伴侣受心理影响更大（48.3%对10.5%，p < 0.001）。经产次数≥1是PPD的保护因素（OR = 0.2，95%置信区间[0.1 - 0.6]，p = 0.003）。PPD的风险因素包括：心理虐待史（OR = 6.4，95%置信区间[1.1 - 37.6]，p = 0.04）、压力性生活事件（OR = 4.5，95%置信区间[1.6 - 12.6]，p = 0.004）以及不良分娩经历（OR = 5.1，95%置信区间[1.4 - 17.8]，p = 0.012）。结论：产后即刻产妇隔离与产后情绪低落的中重度症状发生率增加有关。必须在PPD众所周知的长期后果与伴侣限制进入产科病房的预期益处之间进行权衡。
