Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China.
Jiaxing Center for Disease Control and Prevention, Jiaxing, China.
Front Public Health. 2023 Dec 18;11:1304226. doi: 10.3389/fpubh.2023.1304226. eCollection 2023.
Postpartum depression (PPD) is among the most common postpartum complications. Its prevalence is associated with strong regional variability. Women in rural areas of China have a high risk of PPD. The aim of this study was to investigate the PPD status of women in rural South China and explore the effects of modifiable lifestyle behaviors during pregnancy on their PPD status, thereby providing a scientific basis for the prevention and intervention of PPD in rural China.
A cohort study was conducted on 261 women from four maternal health institutions situated in rural areas of Guangdong Province and the Guangxi Zhuang Autonomous Region from October 2021 to December 2022. The questionnaires were administered to these women to obtain data about sociodemographic characteristics, health literacy, physical activity during pregnancy, and sleep and dietary status during pregnancy, as well as depression status on the 42 day after delivery. The lifestyle behaviors during pregnancy and the PPD status of the study population were analyzed. Multiple linear regression models were used to determine the correlation between lifestyle behaviors and PPD status. Path analysis was performed to explore the interaction between various lifestyle behaviors.
A total of 14.6% of women had a PPD status. Women who continued to work during pregnancy had an Edinburgh Postpartum Depression Scale (EPDS) score of 1.386 points higher than that of women who did not ( = 1.386, = 0.141, = 0.029). For every 1-point increase in the infant feeding-related knowledge score and pregnancy diet diversity score, the EPDS score decreased by 0.188 and 0.484 points, respectively, and for every 1-point increase in the Pittsburgh sleep quality index score, the EPDS score increased by 0.288 points. Age was related to infant feeding-related knowledge (indirect path coefficient = 0.023). During pregnancy, sedentary time was correlated with sleep quality (indirect path coefficient = 0.031) and employment status (indirect path coefficient = 0.043).
Employment status, infant feeding-related knowledge, sleep quality, and diet diversity during pregnancy directly influenced the PPD status, while age and sedentary time during pregnancy indirectly influenced the PPD status. Promoting healthy lifestyle behaviors, including reducing sedentary time, improving sleep quality, and increasing dietary diversity, may be effective in reducing PPD occurrence.
产后抑郁症（PPD）是最常见的产后并发症之一。其流行率与强烈的区域变异性有关。中国农村地区的妇女患 PPD 的风险很高。本研究旨在调查中国南方农村妇女的 PPD 状况，并探讨可改变的妊娠生活方式行为对其 PPD 状况的影响，从而为中国农村地区 PPD 的预防和干预提供科学依据。
2021 年 10 月至 2022 年 12 月，对来自广东省和广西壮族自治区四个农村地区的四家产妇保健机构的 261 名妇女进行了队列研究。通过问卷调查这些妇女，获得了社会人口统计学特征、健康素养、妊娠期间体力活动以及妊娠期间睡眠和饮食状况以及产后 42 天的抑郁状况数据。分析了妊娠期间的生活方式行为和研究人群的 PPD 状况。使用多元线性回归模型确定生活方式行为与 PPD 状况之间的相关性。进行路径分析以探讨各种生活方式行为之间的相互作用。
共有 14.6%的妇女患有 PPD。与不工作的妇女相比，继续工作的孕妇 EPDS 评分高 1.386 分（ = 1.386， = 0.141， = 0.029）。婴儿喂养相关知识评分和妊娠饮食多样性评分每增加 1 分，EPDS 评分分别降低 0.188 和 0.484 分，匹兹堡睡眠质量指数评分每增加 1 分，EPDS 评分增加 0.288 分。年龄与婴儿喂养相关知识有关（间接路径系数 = 0.023）。妊娠期间，久坐时间与睡眠质量（间接路径系数 = 0.031）和就业状况（间接路径系数 = 0.043）相关。
妊娠期间的就业状况、婴儿喂养相关知识、睡眠质量和饮食多样性直接影响 PPD 状况，而妊娠期间的年龄和久坐时间则间接影响 PPD 状况。促进健康的生活方式行为，包括减少久坐时间、改善睡眠质量和增加饮食多样性，可能有助于降低 PPD 的发生。
