性激素、甲状腺激素与产后抑郁及抑郁相关社会心理因素的相关性  

Correlation between the levels of the sex hormones and thyroid hormones of parturients and their postpartum depression and depression-related psychosocial factors

作　　者：张悦 赵宇明 杨青 王晨琛 赵芳 史凤颖 ZHANG Yue;ZHAO Yuming;YANG Qing;WANG Chenchen;ZHAO Fang;SHI Fengying(Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao,Hebei Province,066000;Qinhuangdao First Hospital,Qinhuangdao)

机构地区：[1]河北省秦皇岛市妇幼保健院,066000 [2]河北省秦皇岛市第一医院

出　　处：《中国计划生育学杂志》2025年第1期149-154,共6页Chinese Journal of Family Planning

基　　金：秦皇岛市2023年度市级科学技术研究与发展计划自筹经费项目(202301A253)。

摘　　要：目的:分析性激素、甲状腺激素与产后抑郁及抑郁相关社会心理因素的相关性。方法:纳入2020年6月-2023年6月医院收治的产妇90例,产后3d均接受性激素、甲状腺激素检测,采用社会支持评定量表(SSRS)、自我认同感量表(SIS)、简易应对方式问卷(SCSQ)评估产妇社会心理因素,产后4周内根据爱丁堡产后抑郁量表(EPDS)评分分为抑郁组与正常组,比较两组产后3d性激素、甲状腺激素、社会心理因素3项指标,采用多因素logistic回归分析法分析产后抑郁的危险因素,采用MedCalc分析性激素、甲状腺激素及社会心理因素与EPDS得分的相关性。结果:90例产妇中有17例发生产后抑郁,发生率为18.9%,EPDS得分(14.81±3.15)分(10~19分);产后3d,抑郁组雌二醇(E2)低于正常组,促黄体生成素(LH)、泌乳素(PRL)、睾酮(T)、孕酮(P)高于正常组,促甲状腺激素(TSH)低于正常组,SSRS、SIS、SCSQ积极应对得分低于正常组,SCSQ消极应对得分高于正常组;产后3d产妇E2、TSH水平及SSRS、SIS、SCSQ积极应对得分与EPDS得分呈负相关,PRL、P水平及SCSQ消极应对得分与EPDS得分呈正相关;logistic回归分析,产妇产后E2、TSH、PRL、P、SSRS、SIS、SCSQ异常均是产后发生抑郁的影响因素(均P<0.05)。结论:临床需重视产后女性激素水平及社会心理因素筛查,对合并低水平E2、TSH,高水平PRL、P,SSRS、SIS、SCSQ积极应对得分偏低,SCSQ消极应对得分偏高的产妇,应积极关注其心理健康,警惕产后抑郁的发生。Objective:To analyze the correlation between the levels of the sex hormones and thyroid hormones of parturients and their postpartum depression and depression-related psychosocial factors.Methods:A total of 90 parturients in the hospital from June 2020 to June 2023 were included in this study.All the parturients were tested for the sex hormones and thyroid hormones in the 3rd day after delivery.Social Support Rating Scale(SSRS),Self-Identity Scale(SIS)and Simplified Coping Style Questionnaire(SCSQ)were used to evaluate the social psychosocial factors of these parturients.According to the Edinburgh postnatal depression Scale(EPDS)score of the parturients within 4 weeks after delivery,these parturients were divided into group A(parturients with depression)and group B(parturients without depression).The levels of the sex hormones and thyroid hormones,and the social psychosocial factors of the parturients in the 3rd day after delivery were compared between the two groups.Multivariate logistic regression analysis was used to screen the risk factors of the postpartum depression of the parturients.MedCalc was used to analyze the correlation between the levels of the sex hormones and thyroid hormones,and the psychosocial factors of the parturients and their EPDS score.Results:Among 90 parturients,there were 17 cases with the postpartum depression,with the incidence of the postpartum depression of 18.9%.The EPDS score of 17 parturients ranged from 10 to 19 points,with an average EPDS sore of 14.81±3.15 points.The estradiol(E,)and the thyroid stimulating hormone(TSH)levels of the parturients in group A in the 3rd day after delivery were significantly lower than that of the parturients in group B,and the levels of luteinizing hormone(LH),prolactin(PRL),testosterone(T),progesterone(P)of the parturients in group A in the 3rd day after delivery were significantly higher than those of the parturients in group B.The scores of SSRS,SIS and SCSQ positive coping of the parturients in group A in the 3rd day after delivery were sign

关 键 词：产后抑郁 性激素 甲状腺激素 社会心理因素 危险因素 相关性 

分 类 号：R173[医药卫生—妇幼卫生保健]