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妊娠期和产后抑郁症状:一家三级医院的经验。

Depressive Symptoms during Pregnancy and the Postpartum Period: A Tertiary Hospital Experience.

机构信息

Faculty of Medicine, University of Belgrade, 11000 Beograd, Serbia.

Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia.

出版信息

Medicina (Kaunas). 2024 Aug 9;60(8):1288. doi: 10.3390/medicina60081288.

Abstract

: The prevalence of depressive symptoms during pregnancy is about 20%, and 10-15% in the postpartum period. Suicide is a worrying cause of death among women in these periods. Although ICD-10 lacks specific definitions for perinatal depression (it is planned in ICD-11), the DSM-5 defines it. Various etiological factors and treatment options are being investigated. This study aimed to examine potential etiological factors in order to contribute to potential preventive and therapeutic approaches. A prospective study at the Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, from October 2023 to January 2024 was conducted. Two hundred and five healthy women were surveyed before giving birth (37+ gestational weeks) and 2 weeks and 2 months after childbirth. The following factors were examined: sociodemographic, psychological, and obstetric (using a specially designed questionnaire); relationship quality (DAS-32); and depression, anxiety, and stress symptoms (EPDS; DASS-21). : Depression frequency was 26.3% before childbirth, 20% in the second week, and 21.9% in the second month after delivery. DASS-21 test results showed a statistically significant correlation before delivery and two weeks postpartum ( = 0.02). Factors that are significantly associated with the presence of depressive symptoms include the following: before childbirth-miscarriages ( < 0.01); in the second week after childbirth-personal experiences of a difficult birth ( < 0.01), cesarean delivery instead of planned vaginal delivery ( = 0.03), and application of epidural anesthesia ( = 0.04); and in the second month after childbirth-satisfaction with financial status ( = 0.035). Relationship quality is significantly correlated with DASS-21 test results before childbirth, in the second week, and in the second month after childbirth ( < 0.01), and it is significantly different in women with and without depressive symptoms (before childbirth, in the second week, and in the second month after childbirth, < 0.01). : There are risk factors that can be addressed preventively and therapeutically during pregnancy and in labor. This could be achieved through psychotherapy, partner support, and appropriate management of labor.

摘要

: 怀孕期间出现抑郁症状的比例约为 20%,产后则为 10-15%。自杀是这些时期女性死亡的一个令人担忧的原因。尽管 ICD-10 缺乏围产期抑郁的具体定义(计划在 ICD-11 中制定),但 DSM-5 对其进行了定义。目前正在研究各种病因和治疗选择。本研究旨在探讨潜在的病因因素,以期为潜在的预防和治疗方法做出贡献。 塞尔维亚大学临床中心妇产科于 2023 年 10 月至 2024 年 1 月进行了一项前瞻性研究。在分娩前(37+妊娠周)和分娩后 2 周和 2 个月,对 205 名健康女性进行了调查。检查了以下因素:社会人口统计学、心理和产科因素(使用专门设计的问卷);关系质量(DAS-32);抑郁、焦虑和压力症状(EPDS;DASS-21)。 : 分娩前的抑郁频率为 26.3%,分娩后第 2 周为 20%,第 2 个月为 21.9%。DASS-21 测试结果显示,分娩前和产后两周有统计学显著相关性( = 0.02)。与抑郁症状存在显著相关的因素包括:分娩前-流产( < 0.01);产后第 2 周-个人经历难产( < 0.01)、剖宫产而非计划阴道分娩( = 0.03)和应用硬膜外麻醉( = 0.04);产后第 2 个月-对财务状况的满意度( = 0.035)。关系质量与分娩前、产后第 2 周和第 2 个月的 DASS-21 测试结果显著相关( < 0.01),且在有和无抑郁症状的女性中存在显著差异(分娩前、产后第 2 周和第 2 个月, < 0.01)。 : 存在可在怀孕期间和分娩期间进行预防和治疗的风险因素。这可以通过心理治疗、伴侣支持和适当的分娩管理来实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb7/11356112/a9c543e36457/medicina-60-01288-g001.jpg

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