Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Research Division, Golden Community, Lalitpur, Nepal.
Glob Health Action. 2024 Dec 31;17(1):2381312. doi: 10.1080/16549716.2024.2381312. Epub 2024 Jul 31.
Postpartum depression is associated with low socioeconomic status, adverse birthing processes, and life stress. Increasing evidence of mistreatment during childbirth, negative birth experiences, and poor quality of maternal care is of global concern.
To assess the risk of experiencing depressive symptoms among postpartum women exposed to mistreatment during institutional birthing in Nepal.
We conducted a prospective cohort study from 29 March to 19 August 2022. Of 1629 women who gave birth in a hospital in Nepal, 1222 were assessed for mistreatment during childbirth and depressive symptoms using the Edinburgh Postnatal Depression Scale. We used binomial generalized linear mixed model to examine the risk ratio of postpartum depressive symptoms in women exposed to mistreatment during childbirth.
The prevalence of postpartum depressive symptoms was 4.4%. Women exposed to mistreatment during childbirth were almost fifty percent more likely to have postpartum depressive symptoms (cRR 1.47; 95% CI 1.14, 1.89; = 0.003) compared with the unexposed group. Furthermore, adolescent mothers exposed to mistreatment during childbirth had a seventy percent increased risk of depressive symptoms (aRR 1.72; 95% CI 1.23, 2.41; ). Similarly, women who gave birth to female infants were thirty percent more likely to experience postpartum depressive symptoms (aRR 1.32; 95% CI 1.01-1.74; ).
We observed an association between postpartum depressive symptoms and mistreatment during institutional births in Nepal. The implementation of appropriate respectful maternity care during childbirth and also routine screening for depressive symptoms is critical to improving perinatal mental health and well-being.
产后抑郁症与社会经济地位低下、不良分娩过程和生活压力有关。越来越多的证据表明，分娩过程中受到虐待、负面分娩经历和母婴护理质量差是全球性关注的问题。
评估尼泊尔在机构分娩中受到虐待的产后妇女出现抑郁症状的风险。
我们进行了一项前瞻性队列研究，时间为 2022 年 3 月 29 日至 8 月 19 日。在尼泊尔的一家医院分娩的 1629 名妇女中，有 1222 名妇女使用爱丁堡产后抑郁量表评估了分娩过程中受到虐待和抑郁症状。我们使用二项广义线性混合模型来检验分娩过程中受到虐待的妇女产后抑郁症状的风险比。
产后抑郁症状的患病率为 4.4%。与未暴露组相比，分娩过程中受到虐待的妇女出现产后抑郁症状的可能性几乎高出 50%（cRR 1.47；95%CI 1.14，1.89； = 0.003）。此外，在分娩过程中受到虐待的青少年母亲出现抑郁症状的风险增加了 70%（aRR 1.72；95%CI 1.23，2.41；）。同样，分娩女婴的妇女出现产后抑郁症状的可能性增加了 30%（aRR 1.32；95%CI 1.01-1.74；）。
我们观察到尼泊尔机构分娩中产后抑郁症状与分娩过程中受到虐待之间存在关联。在分娩期间实施适当的尊重产妇护理以及常规筛查抑郁症状对于改善围产期心理健康和幸福感至关重要。
