围产期抑郁发病的社会心理和产科因素分析  

Analysis of psychosocial and obstetric factors of perinatal depression

作　　者：孙国庆 周金玲[2] 靳西龙[3] SUN Guoqing;ZHOU Jinling;JIN Xilong(Mental Health Center,Medical College of Zhejiang University Hangzhou Seventh People's Hospital,Zhejiang Hangzhou 310013,China;Department of Obstetrics,The Affiliated Obstetrical and Gynecological Hospital of Medical College,Zhejiang University,Zhejiang Hangzhou 310006,China;Department of Rehabilitation,The Third People's Hospital of Huzhou City,Zhejiang Huzhou 313000,China)

机构地区：[1]浙江大学医学院精神卫生中心杭州市第七人民医院,浙江杭州310013 [2]浙江大学医学院附属妇产科医院产科,浙江杭州310006 [3]湖州市第三人民医院康复科,浙江湖州313000

出　　处：《中国妇幼健康研究》2020年第3期317-322,共6页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨围产期抑郁症的发病情况及其影响因素。方法于2017年1月至2019年6月,选取210例于浙江大学医学院附属妇产科医院分娩的产妇,通过爱丁堡产后抑郁量表评估研究对象孕早期、孕晚期、产后1周和产后6周抑郁症的发病情况。以诊断为围产期抑郁症的患者为病例组,无围产期抑郁症的产妇为对照组,比较两组社会心理因素和产科因素的差异。结果210例孕产妇中,出现围产期抑郁症51例(包括孕早期9例、孕晚期14例、产后1周13例和产后6周15例),发生率为24.29%。病例组与对照组居住条件、家庭月收入、夫妻关系及婆媳关系的比较差异有统计学意义(χ^2=11.73、9.97、16.32、9.74,均P<0.05)。两组妊娠方式、产期、分娩前对胎儿性别的期待情况及新生儿性别满意度的比较差异有统计学意义(χ^2=23.53、12.72、14.19、7.87,均P<0.05)。经多因素Logistic回归分析显示,居住条件良好、条件环境优美、家庭月收入>10000元、夫妻关系满意、夫妻关系非常满意、婆媳关系满意、婆媳关系非常满意、分娩前对胎儿性别无要求均为孕产妇出现围产期抑郁症的影响因素,其OR值及95%CI分别为0.34(0.18~0.65)、0.02(0.01~0.38)、0.45(0.22~0.95)、0.35(0.14~0.88)、0.70(0.66~0.75)、0.33(0.12~0.90)、0.34(0.15~0.77)、0.13(0.06~0.27)。结论围产期抑郁症可发病于孕产妇孕早、中、晚期及产褥期各个阶段,且其发病与社会、生理、心理等多方面的因素密切相关。较高的家庭月收入、良好的居住条件、良好的夫妻关系和婆媳关系及分娩前对胎儿性别无要求,均是围产期抑郁症发病的保护性因素。Objective To investigate morbidity of perinatal depression and its influencing factors.Methods 210parturients who delivered in The Affiliated Obstetrical and Gynecological Hospital of Medical College,Zhejiang University in a period from January 2017 to June 2019were selected.The incidence of depression in the early pregnancy,late pregnancy,the first week after delivery and the sixth weeks after delivery was evaluated by using Edinburgh Postnatal Depression Scale.The parturients who suffered from perinatal depression were divided into case group and those parturients who didn't suffer from perinatal depression were divided into control group.The differences in psychosocial and obstetric factors between the two groups were compared.Results Among 210parturients,51parturients suffered from perinatal depression(including 9cases occurred in the first trimester,14cases in the third trimester,13cases in the first week after delivery and 15cases in the sixth week after delivery)with the incidence of 24.29%.There were statistically significant differences between the case group and the control group in terms of living condition,monthly family income,husband-wife relationship and mother-in-law and daughter-in-law relationship(χ^2=11.73,9.97,16.32and 9.74,all P<0.05).Also,in pregnancy mode,maturation of the newborn,pregestational expectation for fetal gender and satisfaction for neonatal gender,there were statistically significant differences between the two groups(χ^2=23.53,12.72,14.19and 7.87,all P<0.05).Multivariate logistic regression analysis shown that good living condition,beautiful environment,monthly family income of>10,000 yuan RMB,satisfactory husband-wife relationship,very satisfactory husband-wife relationship,satisfactory and very satisfactory relationships between mother-in-law and daughter-in-law,no requirement on gender of the fetus before delivery were all influencing factors of perinatal depression.The ORvalues(95% CI)were 0.34(0.18~0.65),0.02(0.01~0.38),0.45(0.22~0.95),0.35(0.14~0.88),0.70(0.66~0.75),0.

关 键 词：孕产妇 围产期抑郁 社会心理 产科 影响因素 

分 类 号：R714.7[医药卫生—妇产科学] R749.4[医药卫生—临床医学]