武汉市妇女孕产期抑郁及流入人口产后抑郁的观察性研究

发布时间：2018-04-16 12:09

本文选题：城市妇女 + 农村流入妇女　；参考：《华中科技大学》2014年博士论文

【摘要】：目的：了解武汉城市妇女孕产期抑郁症状的发生情况,掌握城市妇女在整个孕产期抑郁检出情况的动态变化特征,探讨妇女抑郁症状消长的重要影响因素。了解农村流入人口产后抑郁的发生情况,掌握影响产后抑郁的危险因素和保护性因素。比较城市妇女和农村流动妇女产后抑郁检出情况及影响因素的差异。方法：(1)纵向研究。研究人员对孕早期妇女进行基线调查和抑郁评估,随后由社区医生在孕中、晚期以及产后1个月、3个月定期开展入户调查。所有研究对象在每次随访时填写调查问卷,并用爱丁堡产后抑郁量表(EPDS)进行抑郁评分。(2)横断面研究。对满足条件的农村流动产妇进行问卷调查,并用EPDS进行抑郁评估。结果：(1)武汉市妇女在整个孕产期的抑郁检出率在孕期表现出一定特征,即在孕期随着妊娠周期增加抑郁检出率逐渐上升,在产后1个月和产后3个月的抑郁检出率保持着较高的水平。武汉市孕产妇在孕期抑郁测评均分呈现“U”型分布,产后EPDS均分从产后1个月至产后3个月呈明显下降趋势。(2)Logistic回归分析显示,孕早期抑郁的影响因素为：对孕期饮食不满意、发生对精神有影响的负性生活事件；孕中期抑郁的影响因素有：发生对精神有影响的负性生活事件；孕晚期抑郁的影响因素有对家人照顾不满意、发生对精神有影响的负性生活事件；产后1个月抑郁的影响因素有：丈夫对自己关心满意度低、对产后居住条件满意度低、对产后身材恢复不满意、发生对精神有影响的负性生活事件；产后3个月抑郁的影响因素有：丈夫对自己关心满意度低、有向宝宝发泄情绪的冲动、为产后经济状况担忧。(3)武汉地区农村流入人口抑郁症检出率高,产后抑郁检出率和EPDS均分高于城市居民。多因素logistic回归分析的结果显示无医疗保险、照看孩子感觉累、丈夫对妻子关心程度一般和根本不关心、对居住条件不满意和生活中存在压力事件是农村女性流入人口发生产后抑郁的危险因素。结论：(1)武汉市妇女孕期抑郁检出率随着孕周增加而增加,产后随着休养时间延长,产后抑郁检出率仍保持较高水平。(2)武汉市妇女的EPDS均分在孕期呈“U”型分布,产后随着休养时间延长,EPDS均分显著下降。(3)患抑郁的孕妇在产后的抑郁症状降低,产后抑郁水平下降明显,提示武汉武汉市妇女的抑郁症状在产后具有一定的自我康复能力。(4)农村流入人口的产后抑郁检出率和患病水平较高,远高于武汉市本地户籍妇女。无医疗保险、照看孩子累、丈夫对妻子照顾一般、对居住条件不满、产后不良生活事件是农村流入妇女产后抑郁的高危因素。
[Abstract]:Objective: to understand the occurrence of depressive symptoms in urban women during pregnancy and childbirth in Wuhan, and to understand the dynamic changes of depressive symptoms in urban women during pregnancy and childbirth, and to explore the important influencing factors of depressive symptoms in urban women.To understand the incidence of postpartum depression and the risk factors and protective factors of postpartum depression.To compare the detection and influence factors of postpartum depression between urban women and rural migrant women.Methods Vertical study.The researchers conducted baseline surveys and depression assessments of women in early pregnancy, followed by regular household surveys by community doctors during, late and one month after pregnancy, and three months after delivery.All the subjects completed the questionnaire at each follow-up, and used the Edinburgh postpartum Depression scale (EPDS) to carry out the depression score. 2) Cross-sectional study.A questionnaire survey was conducted on rural migrant women who met the conditions, and depression was evaluated with EPDS.Results (1) the prevalence rate of depression in Wuhan women showed certain characteristics during pregnancy, that is, the rate of depression increased gradually with the increase of pregnancy cycle.The detectable rate of depression maintained a high level at 1 month postpartum and 3 months postpartum.The average score of depression in pregnant women in Wuhan showed a "U" type distribution. The average score of postpartum EPDS decreased significantly from 1 month to 3 months after delivery. Logistic regression analysis showed that the influencing factors of depression in early pregnancy were: dissatisfied with diet during pregnancy.The influencing factors of depression in the second trimester of pregnancy are: the negative life events which have an effect on the mind, and the influencing factors of depression in the third trimester of pregnancy are not satisfied with the care of the family.The influencing factors of depression after one month of postpartum were: husband's low satisfaction with his care, low satisfaction with postpartum living conditions, and dissatisfied with postpartum figure recovery.The influencing factors of depression after 3 months of postpartum were: the husband's low satisfaction with his care and the impulse to vent his emotions on the baby.The incidence of depression in rural inflow population in Wuhan area was higher than that in urban residents, and the average score of postpartum depression and EPDS was higher than that of urban residents.The results of multivariate logistic regression analysis showed that there was no medical insurance, that the child was tired, that the husband cared for his wife generally and that he did not care at all.Dissatisfaction with living conditions and stress events in life are the risk factors of postpartum depression in rural women.Conclusion (1) the prevalence rate of depression during pregnancy increases with the increase of gestational weeks in Wuhan, and the detection rate of postpartum depression remains at a high level with the prolongation of rest and recuperation.) the mean score of EPDS of women in Wuhan is "U" type distribution during pregnancy.As the rest and recuperation time prolonged, the mean score of EPDS decreased significantly. (3) the depression symptoms of pregnant women with depression decreased significantly, and the level of postpartum depression decreased significantly.It is suggested that the postpartum depression of Wuhan women has a certain ability of self-rehabilitation. 4) the incidence of postpartum depression and the prevalence of postpartum depression in the rural areas are higher than those of the local Hukou women in Wuhan.Without medical insurance, child care is tired, husband takes care of his wife generally, and he is dissatisfied with living conditions. The adverse life events after childbirth are the high risk factors of postpartum depression for rural women.
【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R749.4

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