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产后抑郁及其决定因素:一项横断面研究。

Postpartum Depression and Its Determinants: A Cross-Sectional Study.

作者信息

Kumari Puja, Basu Saurav

机构信息

Epidemiology and Public Health, Indian Institute of Public Health-Delhi, Delhi, IND.

Community Medicine, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Kolkata, IND.

出版信息

Cureus. 2024 Nov 19;16(11):e74044. doi: 10.7759/cureus.74044. eCollection 2024 Nov.

Abstract

Background Postpartum depression (PPD) is the most prevalent psychological disorder after childbirth associated with a negative impact on the daily functioning of mothers and the cognitive development of infants. Inequitable primary mental health access in lower-middle-income countries (LMICs) further aggravates this major public health problem. Objective The objective of this study is to estimate the prevalence and determinants of PPD among women reporting to secondary care facilities in Delhi, India. Methods A cross-sectional study was conducted in the outpatient settings of two secondary care (one government and one private) hospitals in the Delhi-National Capital Region among mothers of infants aged below six months. The study was conducted from January to June 2023. Data were collected by a single trained investigator using a self-designed interview schedule, while PPD was measured by administering the Edinburgh Postnatal Depression Scale (EPDS). Data were analyzed with Stata statistical software, version 15.1 (StataCorp LLC, College Station, TX). P < 0.05 was considered statistically significant. Results The mean age of the study participants was 28.49 ± 3.77 years with 53 (18.28%) detected as having possible postpartum depression on screening with the EPDS. On adjustment for covariates, the participants with husbands consuming alcohol (adjusted odds ratio, 6.97; 95% confidence interval {CI}, 2.73-17.8), those who underwent C-section (adjusted odds ratio, 4.39; 95% CI, 1.02-18.85), and those giving birth in private hospitals (adjusted odds ratio, 5.48; 95% CI, 1.53-19.55) had significantly higher odds of having PPD. In contrast, mothers staying at home (not employed) (adjusted odds ratio, 0.08; 95% CI, 0.02-0.41), without specific preference for the newborn's gender (adjusted odds ratio, 0.07; 95% CI, 0.01-0.78), and those living in nuclear families (adjusted odds ratio, 0.03; 95% CI, 0.005-0.19) had significantly lower odds of PPD. Conclusion Nearly one in five mothers were screened for having possible PPD. Prioritizing birth preparedness during the antenatal period and strengthening health system screening protocols may prevent and mitigate the effects of PPD.

摘要

背景

产后抑郁症(PPD)是产后最常见的心理障碍,对母亲的日常功能和婴儿的认知发展有负面影响。低收入和中等收入国家(LMICs)初级心理健康服务的不平等进一步加剧了这一重大公共卫生问题。

目的

本研究的目的是估计印度德里二级医疗设施中报告的妇女产后抑郁症的患病率及其决定因素。

方法

在德里国家首都辖区的两家二级医疗(一家政府医院和一家私立医院)医院的门诊环境中,对6个月以下婴儿的母亲进行了一项横断面研究。该研究于2023年1月至6月进行。由一名经过培训的调查员使用自行设计的访谈问卷收集数据,同时通过使用爱丁堡产后抑郁量表(EPDS)来测量产后抑郁症。使用Stata统计软件15.1版(StataCorp LLC,德克萨斯州大学站)对数据进行分析。P<0.05被认为具有统计学意义。

结果

研究参与者的平均年龄为28.49±3.77岁,其中53人(18.28%)在使用EPDS筛查时被检测出可能患有产后抑郁症。在对协变量进行调整后,丈夫饮酒的参与者(调整后的优势比,6.97;95%置信区间{CI},2.73-17.8)、接受剖宫产的参与者(调整后的优势比,4.39;95%CI,1.02-18.85)以及在私立医院分娩的参与者(调整后的优势比,5.48;95%CI,1.53-19.55)患产后抑郁症的几率显著更高。相比之下,待在家中(未就业)的母亲(调整后的优势比,0.08;95%CI,0.02-0.41)、对新生儿性别无特定偏好的母亲(调整后的优势比,0.07;95%CI,0.01-0.78)以及生活在核心家庭的母亲(调整后的优势比,0.03;95%CI,0.005-0.19)患产后抑郁症的几率显著更低。

结论

近五分之一的母亲被筛查出可能患有产后抑郁症。在产前阶段优先做好分娩准备并加强卫生系统筛查方案可能预防和减轻产后抑郁症的影响。

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