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尼泊尔鲁潘德希县拜拉哈瓦市通用医学院及教学医院产后母亲的抑郁症及其决定因素

Depression and Its Determinants among Postpartum Mothers Attending at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Rupandehi, Nepal.

作者信息

Bhusal Chet Kant, Bhattarai Sigma, Shrestha Alisha, Sharma Hem Raj

机构信息

Department of Community Medicine, Universal College of Medical Sciences and Teaching Hospital Affiliated to Tribhuvan University, Bhairahawa, Rupandehi, Nepal.

Department of Nursing, Universal College of Medical Sciences and Teaching Hospital Affiliated to Tribhuvan University, Bhairahawa, Rupandehi, Nepal.

出版信息

Int J Pediatr. 2023 Jul 26;2023:1331641. doi: 10.1155/2023/1331641. eCollection 2023.

Abstract

BACKGROUND

Postpartum depression is a serious mental health issue linked to maternal morbidity and negative effects for infant's normal growth, development, and well-being. This study is aimed at assessing the prevalence and factors associated with postpartum depression among mothers attending a tertiary hospital in Nepal.

METHODS

A hospital-based cross-sectional study was conducted among 173 postpartum mothers (<6 weeks postdelivery) who were receiving care either at the postnatal ward or immunization clinic of Universal College of Medical Sciences and Teaching Hospital in Bhairahawa, Rupandehi district, Nepal. The study was carried out from October 2020 to February 2021 by using purposive sampling technique for selecting respondents. The variables that showed significant association with the dependent variable having value < 0.05 in bivariate analysis were entered into multivariate logistic regression model to find the final associated factors.

RESULTS

The prevalence of postpartum depression was 20.2% among mothers attending a tertiary hospital in Nepal. The mean age of the respondents was 24.77 ± 3.47. Factors such as mothers having female child (AOR = 6.39, CI = 1.54 - 26.46), unplanned pregnancy (AOR = 10.08, CI = 2.91 - 34.94), pregnancy-induced health problems (AOR = 9.68, CI: 3.51-26.64) were associated with an increased risk of postpartum depression. Similarly, mothers having formal education (AOR = 0.28, CI: 0.08-0.91), whose spouses have secondary and above education (AOR = 0.16, CI: 0.03-0.85), and who have ≥4 ANC visits (AOR = 0.15, CI = 0.05 - 0.40) were significantly associated but have a protective effect with postpartum depression.

CONCLUSIONS

Sex of newborn, mother's and spouse's education, intention of pregnancy, ANC visits, and pregnancy-induced health problems were found to be significantly associated with postpartum depression. Hence, specific health education program regarding maternal and child health integrating mental health should be provided to pregnant women, mothers, and their husbands, focusing on gender discrimination. Similarly specific orientation program should be provided to local health worker about the importance of planned pregnancy, in order to reduce pregnancy related health problems during ANC visits and to mothers after their delivery to reduce further chances of postpartum depression.

摘要

背景

产后抑郁症是一个严重的心理健康问题,与产妇发病以及对婴儿正常生长、发育和福祉的负面影响有关。本研究旨在评估尼泊尔一家三级医院中产后母亲产后抑郁症的患病率及其相关因素。

方法

在尼泊尔鲁潘德希县拜拉哈瓦市通用医学科学与教学医院的产后病房或免疫诊所接受护理的173名产后母亲(产后<6周)中开展了一项基于医院的横断面研究。该研究于2020年10月至2021年2月进行,采用目的抽样技术选取受访者。在双变量分析中与因变量显著相关(P值<0.05)的变量被纳入多因素逻辑回归模型,以找出最终的相关因素。

结果

在尼泊尔一家三级医院就诊的母亲中,产后抑郁症的患病率为20.2%。受访者的平均年龄为24.77±3.47岁。诸如生育女孩的母亲(调整后比值比[AOR]=6.39,可信区间[CI]=1.54 - 26.46)、意外怀孕(AOR = 10.08,CI = 2.91 - 34.94)、妊娠相关健康问题(AOR = 9.68,CI:3.51 - 26.64)等因素与产后抑郁症风险增加相关。同样,接受过正规教育的母亲(AOR = 0.28,CI:0.08 - 0.91)、配偶具有中学及以上学历的母亲(AOR = 0.16,CI:0.03 - 0.85)以及产前检查次数≥4次的母亲(AOR = 0.15,CI = 0.05 - 0.40)也存在显著关联,但对产后抑郁症具有保护作用。

结论

发现新生儿性别、母亲及配偶的教育程度、怀孕意愿、产前检查次数以及妊娠相关健康问题与产后抑郁症显著相关。因此,应向孕妇、母亲及其丈夫提供关于母婴健康并整合心理健康的特定健康教育项目,重点关注性别歧视。同样,应向当地卫生工作者提供关于计划生育重要性的特定培训项目,以减少产前检查期间与妊娠相关的健康问题,并减少产后母亲患产后抑郁症的进一步几率。

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Risk Factors for Postpartum Depression: An Umbrella Review.产后抑郁症的危险因素:伞式综述。
J Midwifery Womens Health. 2020 Jan;65(1):96-108. doi: 10.1111/jmwh.13067. Epub 2020 Jan 22.

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