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发展中国家患有妊娠高血压疾病的产后母亲中产后抑郁症的患病率及危险因素

Prevalence and risk factors of postpartum depression among postnatal mothers with hypertensive disorders of pregnancy in a developing country.

作者信息

Ofori Boadu Wina Ivy, Anto Enoch Odame, Wiafe Edmund Mintah, Nyantakyi Michael, Frimpong Joseph, Korsah Emmanuel Ekow, Ansah Ezekiel, Kwayie Afia Agyapomaa, Aboagye Elizabeth, Obirikorang Christian, Donkoh Emmanuel Timmy, Boadu Kwame Ofori

机构信息

Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.

出版信息

Womens Health (Lond). 2025 Jan-Dec;21:17455057251338938. doi: 10.1177/17455057251338938. Epub 2025 Jun 14.

Abstract

BACKGROUND

Postpartum depression is a public health issue affecting both maternal well-being and child development. While it is the most common mental health disorder following childbirth, data on its prevalence and associated risk factors in developing countries, including Ghana, remains limited.

OBJECTIVES

This study determined the prevalence of postpartum depression and identified its associated risk factors among pregnant women who developed hypertensive disorders of pregnancy at the Adabraka Polyclinic in the Greater Accra Region of Ghana.

DESIGN

This study was a hospital-based cross-sectional study.

METHODS

This hospital-based cross-sectional study was conducted on 159 postnatal mothers who delivered between March 31, 2023 and May 31, 2023 at the Adabraka Polyclinic in the Greater Accra Region of Ghana. Participants were selected using purposive sampling. The data collection instrument were developed to gather information on sociodemographic, psychosocial, obstetric, and newborn characteristics. The Edinburgh Postnatal Depression Scale was used to investigate depressive symptoms in the mothers. Mothers with Edinburgh Postnatal Depression Scale scores above 12 or 13 were considered likely to be experiencing depression.

RESULTS

Out of the 159 women followed to term, 74 were diagnosed with postpartum depression (Edinburgh Postnatal Depression Scale scores above 12 or 13), indicating a prevalence rate of 46.5%. The majority of these women were aged between 25 and 30 years (46.5%), engaged in informal occupations (52.2%), had multiple children (71.1%), pregnancies (69.2%), and normal blood pressure levels (62.3%). After adjusting for potential confounders in a multivariate logistic model, several factors were found to be independently associated with postpartum depression: informal occupation (adjusted odd ratio = 0.12, 95% confidence interval (0.02-0.62),  = 0.012), Ga ethnicity (adjusted odd ratio = 5.27, 95% confidence interval (1.25-22.11),  = 0.023), sub-optimal financial support from partner (adjusted odd ratio = 27.54, 95% confidence interval (4.63-164.00),  < 0.001), and experience of cesarean section (adjusted odd ratio = 22.10, 95% confidence interval (3.90-125.08),  < 0.001).

CONCLUSION

Pregnant women with hypertensive disorders may face a heightened risk of experiencing postpartum depression. Timely recognition and intervention are vital for enhancing the health and welfare of both mothers and their children.

摘要

背景

产后抑郁症是一个影响产妇身心健康和儿童发育的公共卫生问题。虽然它是分娩后最常见的心理健康障碍,但在包括加纳在内的发展中国家,关于其患病率及相关风险因素的数据仍然有限。

目的

本研究确定了加纳大阿克拉地区阿德拉卡综合诊所患有妊娠高血压疾病的孕妇中产后抑郁症的患病率,并确定了其相关风险因素。

设计

本研究是一项基于医院的横断面研究。

方法

这项基于医院的横断面研究对2023年3月31日至2023年5月31日在加纳大阿克拉地区阿德拉卡综合诊所分娩的159名产后母亲进行。采用目的抽样法选取参与者。开发了数据收集工具以收集有关社会人口学、心理社会、产科和新生儿特征的信息。使用爱丁堡产后抑郁量表调查母亲的抑郁症状。爱丁堡产后抑郁量表得分高于12或13的母亲被认为可能患有抑郁症。

结果

在随访至足月的159名女性中,74名被诊断为产后抑郁症(爱丁堡产后抑郁量表得分高于12或13),患病率为46.5%。这些女性大多数年龄在25至30岁之间(46.5%),从事非正规职业(52.2%),有多个孩子(71.1%)、多次怀孕(69.2%)且血压正常(62.3%)。在多变量逻辑模型中对潜在混杂因素进行调整后,发现几个因素与产后抑郁症独立相关:非正规职业(调整后的比值比=0.12,95%置信区间(0.02 - 0.62),P = 0.012)、加族(调整后的比值比=5.27,95%置信区间(1.25 - 22.11),P = 0.023)、伴侣提供的经济支持不足(调整后的比值比=27.54,95%置信区间(4.63 - 164.00),P < 0.001)以及剖宫产经历(调整后的比值比=22.10, 95%置信区间(3.90 - 125.08),P < 0.001)。

结论

患有妊娠高血压疾病的孕妇可能面临更高的产后抑郁症风险。及时识别和干预对于提高母亲及其子女的健康和福祉至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563e/12171256/dfa0b4518836/10.1177_17455057251338938-fig1.jpg

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