Study Of Psychosocial Factors For Postpartum Depression Among 479 Women

ObjectivesThe study aimed to investigate the prevalence of postpartum depression among women in Wuhan City. We explored the associated influencing factors from social and psychological aspects to understand the causes of postpartum depression.By determining how the factors that resulted in the postpartum depression among woman who experienced a delivery of baby, specific prevention programs aiming at the high-risk woman were developed. This study also provided new evidence in terms of women's mental health adjustment and the development of neonatal physical and mental health.Methods479 women who made prenatal examination in 4 weeks before delivery in Wuchang Hospital and an affiliated hospital of Wuhan University of Science and Technology from January 2009 to January 2011, and accorded with the inclusion criteria were included in our study. Baseline survey was completed within 4 weeks before the delivery for each woman. Re-assessment process was done during the 7d to 30d after the delivery. Subjects were divided into two groups (case and control) according to the score of BDI (cutoff point=5). Finally, there were 167 cases (BDI>5) and 312 controls (BDI<5). In the baseline assessment, the medical staff collected socio-demographic characteristics, medical and obstetric history data as well as the potential risk factors of the 479 women by using a semi-style questionnaire. Those risk factors cannot be collected at the baseline survey were observed in the follow-up evaluation procedure. Statistic calculations were performed using statistical software SPSS 17.0. Descriptive analysis, t test, Chi-square test and logistic regression were conducted to analyze the data.Results1.Summarized information Among 479 women who lived in the town accounted for 91.3%. The youngest and the oldest were 19 and 40 years old, respectively.274 women aged between 27 to 32 years old, which accounted for 57.3% of total women. About education level,339 women completed college education (70.8%), followed by middle and high school of 135 cases (28.2%), primary and lower in 5 cases (1%).34% women who were business staff, followed by 24.2% who had own businesses.13.6% women were medical staff and 10.7% worked in administration and management apartment. Technologist accounted for 9.8% of the women and the rest of people were taking other jobs. In this study,90% women were primipara; 28.2% women were high-risk puerperal; 34% women had menstrual syndrome; 52.4% had antenatal depression; 57.3% women participated in the maternal health care training and 30.1% women expected the fetus who is male. During the first month after delivery,57.2% women felt excessive physically and emotionally when feeding the baby; 21.4% women had the impulse of wanting to vent their emotions to the newborn; 47.4% women were taken care by husband's family and 51.9% women thought their husband was considerate.2. Prevalence of postpartum depression among the 479 woman The rate of postpartum depression for women who had mild depression was 19.4%(93/479); for women who had moderate depression was 14.6%(70/479), and for women who had severe depression was 0.84%(4/479). The total prevalence rate of postpartum depression was 34.9%(167/479).Results from univariate analysis displayed that the two groups did not differ significantly with respect to age, education level, vocation, family income, marital relationship, whether having menstrual syndrome, sleep quality during pregnancy, social support, mode of delivery, labors and having fatigues physically and mentally when feeding the baby (P>0.05).3. Psychosocial factors of postpartum depressionHigh risk pregnancy, the trait coping style, prenatal depression, expecting a boy both from the woman and her husband, care-giver, husband's attitude, and having the impulse of wanting to vent their emotions to the newborn were the significant factors to having the risk of postpartum depression (P<0.05).Results from logistic regression showed that high risk pregnancy, looked forward to having a boy, prenatal depression, had postpartum care by husband'family, bad attitude toward the woman from her husband and had fatigues physically and mentally when feeding the baby was more likely to have postpartum depression.Conclusions1. The incidence of postpartum depression in Wuhan is high.2. Puerpera who had a negative attitude, looked forward to having a boy but having female newborns, had postpartum care by husband'family, bad attitude from husband and lack of parental knowledge and experience was more likely to have postpartum depression. women had less contact with the outside world during the first month after they gave birth. They considerably counted on their caretakers and husbands. Therefore, family support, especially husband's care for women during pregnancy is greatly important.3. Education and dissemination of knowledge about maternal health care remains to be improved. The lack of knowledge related to health and child care will increase negative emotion among the pregnant and lying-in women.4. Prenatal depression is an important psychological factor of postpartum depression, and which should be taken into account by pregnant women and their families. The incidence of postpartum depression is not only related to physical and mental health and family environment of the puerpera, but also associated with some social customs. Psychological counseling is one of the best ways to help pregnant women to get through the "psychological degradation" smoothly.5. The puerpera and her family should change their attitude on the sex of a baby, not believing some superstitious confinement custom. In the same time, the woman who gave a birth ought to arrange life more reasonably, eat scientifically, sleep regularly and do moderate exercise routinely. Also, the women can take part in some meaningful activities, and exchange maternal and child care knowledge with the people who had given birth too.6. Health care service organization could provide targeted advices to help the pregnant women reduce depression. During the month after delivery, it is best to arrange an experiencing woman to provide consulting services at any time to help mothers lower their worries and doubts as to minimize depression risk factors. At the same time, screening out the women who have high risk of perinatal depression as early as possible and providing them with proper consultation can greatly prevent the occurrence of postpartum depression.