Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand.
Faculty of Nursing and Public Health, Thimphu, Bhutan.
Womens Health Nurs. 2024 Sep;30(3):238-249. doi: 10.4069/whn.2024.09.02. Epub 2024 Sep 30.
This study investigated the prevalence of postpartum depression (PPD) and explored associated factors among mothers attending postnatal care in Bhutan.
A cross-sectional study was conducted from August to November 2023 at a national referral hospital in Thimphu, the capital city of Bhutan. In total, 314 mothers were recruited. Sociodemographic, psychosocial, obstetric, and infant-related data were collected using questionnaires. The Edinburgh Postnatal Depression Scale, with a threshold of ≥11, was employed to screen for PPD, and logistic regression was used to test the potential factors.
The prevalence of PPD was 14.97%. Mothers with a perceived change in body image (adjusted odds ratio [AOR], 4.40; 95% confidence interval [CI], 1.91-10.17; p=.001), perceived heightened stress after delivery (AOR, 3.74; 95% CI, 1.45-9.67; p=.006), poor relationship with inlaws (AOR, 2.57; 95% CI, 1.24-5.30; p=. 011), and negative birth experience (AOR, 2.42; 95% CI, 1.17-5.00; p=.016) demonstrated significantly higher odds of developing PPD. However, mothers with a higher monthly family income (Bhutanese ngultrum [Nu.] 20,000 to <50,000; AOR, 0.35; 95% CI, 0.13-0.92; p=.033), ≥Nu. 50,000 (AOR, 0.37; 95% CI, 0.13-1.07, p=.067) compared to <Nu. 20,000, and advanced gestational age (37 to <41 weeks; AOR, 0.25; 95% CI, 0.09-0.71; p=.009) and ≥41 weeks (AOR, 0.08; 95% CI, 0.00-0.75; p=.028) compared to <37 weeks had significantly lower risks of PPD.
To mitigate the prevalence and risk of PPD, prioritizing screening strategies and interventions may benefit mothers with perceived changes in body image and heightened perceived stress after delivery, poor relationships with in-laws, and those with negative birth experiences.
本研究旨在调查不丹接受产后护理的母亲中产后抑郁症（PPD）的患病率，并探讨其相关因素。
本横断面研究于 2023 年 8 月至 11 月在不丹首都廷布的一家国家转诊医院进行。共招募了 314 名母亲。使用问卷收集社会人口学、心理社会、产科和婴儿相关数据。采用爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale），得分≥11 分筛查 PPD，并采用逻辑回归检验潜在因素。
PPD 的患病率为 14.97%。与身体形象感知变化（调整优势比 [AOR]，4.40；95%置信区间 [CI]，1.91-10.17；p=.001）、分娩后感知压力增加（AOR，3.74；95% CI，1.45-9.67；p=.006）、与公婆关系不佳（AOR，2.57；95% CI，1.24-5.30；p=.011）和负面分娩经历（AOR，2.42；95% CI，1.17-5.00；p=.016）的母亲相比，出现 PPD 的几率明显更高。然而，与家庭月收入较低（不丹努尔特鲁姆[Nu.]20000 至<50000）的母亲相比，收入较高（Nu.50000 及以上：AOR，0.35；95% CI，0.13-0.92；p=.033）和收入非常高（Nu.50000 及以上：AOR，0.37；95% CI，0.13-1.07；p=.067）以及妊娠周数较长（37 至<41 周：AOR，0.25；95% CI，0.09-0.71；p=.009）和非常长（≥41 周：AOR，0.08；95% CI，0.00-0.75；p=.028）的母亲出现 PPD 的风险显著降低。
为了降低 PPD 的患病率和风险，优先考虑筛查策略和干预措施可能有益于那些感知到身体形象变化和分娩后压力增加、与公婆关系不佳以及有负面分娩经历的母亲。
