全程导乐陪伴分娩对产后抑郁症发病的影响  

The Influence of Doula Labor for Company the Whole Course on the Onset of Puerperal Depression

作　　者：周敬珍[1] 尹春艳[1] 贾晓江[1] 李秋玲[1] 

机构地区：[1]广东省第二人民医院产科,广东省广州市510317

出　　处：《中国全科医学》2005年第18期1488-1489,共2页Chinese General Practice

基　　金：广东省医学科研基金(A2004518)

摘　　要：目的调查产后抑郁症的相关因素,探讨全程导乐陪伴分娩对产后抑郁症发病的影响。方法选择在我院行产前检查且自愿要求全程导乐陪伴分娩的产妇856例为观察组,选择同期、同数量定期产检,但未行全程导乐陪伴分娩的产妇为对照组。对两组孕妇于孕期行医院焦虑-抑郁情绪自评量表(HAD)测试(≥11分为焦虑-抑郁情绪);产后行艾迪产后抑郁量表(EPDS)测试(≥13分诊断为产后抑郁症)。两组中部分产妇采用艾森克个性量表(EPQ)做个性因素分析(N量表为情绪性,P量表为变态心理倾向或神经质)。观察两组产妇产后抑郁症的发生率。结果(1)HAD≥11分:观察组为96例(11·2%),对照组为95例(11·1%),两组间差别有显著性意义(P<0·01)。(2)EPDS≥13分:观察组为18例(21·0%);对照组为73例(8·53%),两组间差别有显著性意义(P<0·01)。(3)产后抑郁症患者N量表评分和P量表评分明显高于产后无抑郁症者(P<0·01)。结论全程导乐陪伴分娩能有效阻断产前焦虑-抑郁情绪、不良个性因素、产后心理及生理变化等高危因素;显著降低产后抑郁症的发生率。Objective To investigate the correlative factors of puerperal depression and to explore the influence of Doula labor for the whole course on the onset of puerperal depression. Methods 856 parturients,who were examined and asked for Doula labor to company the whole course voluntarily were selected as Doula group,and at the same time,856 cases,who were examined periodically but not selected Doula labor for company the whole course, were selected as the control group. The gravida of two groups was tested according to HAD ≥11 scores （ meaning anxiety - depressive emotion） on the gestational period and postpartum according to EPDS ≥ 13 scores （ meaning puerperal depression）. The personality factors of part of the cases were analyzed on the basis of EPQ （ N amount form was emotion ; P amount form was abnormalpsychological tendency or nervosity ）. The change of the incidence of puerperal depression was observed between the two groups. Results （ 1 ） HAD was not less than 11 scores （worry-depression） ： there were 96 cases in Doula group （ 11.2% ） ,95 cases in the control group （ 11. 1% ）. There was extremely significant difference between two groups （ P 〈0. 01 ）. （2） EPDS was not less than 13 scores （postpartum depression） ：18 cases was in Doula group, the incidence of puerperal depression was 2. 10% （ 18/856 ） ;73 cases were in the control group, the incidence of puerperal depression was 8. 53% （73/856）. There was extremely significant difference between two groups （ P 〈0. 01 ）. （3） The mark of N amount form and P amount form of puerperal depression in EPQ test were remarkable higher than those of normal gravida without puerperal depression （ P 〈0. 01 ）. Conclusion Doula labor for company the whole course can effectively block the high risk pathogenic factors including antepartum anxiety - depression emotion, bad personality factors and postpartum psychological and physiological change and remarkably decrease the incidence of puerperal depression.

关 键 词：全程导乐陪伴分娩 抑郁症 产后 

分 类 号：R473.71[医药卫生—护理学]