Fang Li, Ye Shan, Sun Guoquan, Liu Ling, Xie Shiyi, Hu Yan, Yang Yang, Fang Marong, Hu Zhiying
Department of Obstetrics and Gynecology, Zhejiang University of Traditional Chinese Medicine Affiliated Integrated Chinese and Western Medicine Hospital, Hangzhou, China.
The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China.
Psychol Health Med. 2023 Jul-Dec;28(9):2462-2473. doi: 10.1080/13548506.2023.2208366. Epub 2023 May 1.
Postpartum depression (PPD) is a major public health problem that has negative effects on mothers, infants, and society. This study was aimed at investigating the prevalence of PPD and elucidating the delivery factors implicated in PPD so as take more targeted measures for reducing the potential risk factors. A prospective cohort study was conducted. Following the criterion, 151 pregnant women were included in the study. The Edinburgh Postpartum Depression Scale (EPDS) and the general questionnaire were filled out 2-3 days after delivery. At weeks 2 and 6 postpartum, the EPDS was reassessed either online or via telephone. Also, electronic medical records based on relevant information during the delivery period were collected. Statistical significance was defined as < 0.05. A high rate of PPD (31.13%) was reported. Univariate correlation analysis showed statistically significant differences in the husband-wife relationship (χ = 18.497, < 0.001), neonatal health (χ = 14.710, < 0.001), and breast milk volume (χ = 5.712, = 0.017) between PPD and normal control groups. Adjusting for other covariates, multivariate logistic regression analysis showed that satisfactory conjugal relation could reduce the risk of PPD (OR, 0.053; = 0.022); Neonatal health problems significantly increase the risk of PPD (OR, 6.497; = 0.001); Adequate breast milk could alleviate the risk of PPD (OR, 0.351; = 0.045). Data analysis suggests that marital discord and unhealthy new-born are independent risk factors; nevertheless, sufficient breast milk is a protective factor against PPD. Healthcare workers such as hospital and community doctors and social workers should pay attention to PPD. Furthermore, perinatal emotional support, health education, and EPDS assessment need to be incorporated into maternity care. Screening and personalized psychological counselling should be carried out for high-risk pregnant women with PPD.
产后抑郁症（PPD）是一个重大的公共卫生问题，对母亲、婴儿和社会都有负面影响。本研究旨在调查PPD的患病率，并阐明与PPD相关的分娩因素，以便采取更有针对性的措施来降低潜在风险因素。进行了一项前瞻性队列研究。按照标准，151名孕妇被纳入研究。在分娩后2 - 3天填写爱丁堡产后抑郁量表（EPDS）和一般问卷。在产后第2周和第6周，通过在线或电话方式重新评估EPDS。此外，收集了基于分娩期间相关信息的电子病历。统计学显著性定义为<0.05。报告的PPD发生率较高（31.13%）。单因素相关分析显示，PPD组与正常对照组在夫妻关系（χ = 18.497，<0.001）、新生儿健康（χ = 14.710，<0.001）和母乳量（χ = 5.712，= 0.017）方面存在统计学显著差异。在调整其他协变量后，多因素逻辑回归分析显示，满意的婚姻关系可降低PPD风险（OR，0.053；= 0.022）；新生儿健康问题显著增加PPD风险（OR，6.497；= 0.001）；充足的母乳可减轻PPD风险（OR，0.351；= 0.045）。数据分析表明，婚姻不和与新生儿健康不佳是独立的风险因素；然而，充足的母乳是预防PPD的保护因素。医院和社区医生以及社会工作者等医护人员应关注PPD。此外，围产期情感支持、健康教育和EPDS评估应纳入孕产妇保健。应对有PPD的高危孕妇进行筛查和个性化心理咨询。
