A Study Of The Psychosocial Risk Factors Of Postpartum Depression By Screening And The Effect Of Comprehensive Intervention Measures

Objective:To explore the incidence and related protective or risk factors of postpartum depression by questionnaire survey. The effect of comprehensive intervention measures based on our screening study has also been evaluated.Material and Method:A total 800 voluntary lying-in mothers without any amentia, cerebral injury and mental disease were recruited in our screening study from May 2008 to Sept 2008 as our control. General Situation Questionnaire and the Edinburgh Postnatal Depression Scale (EPDS) were used to screen postpartum depression and study related factors of this disease. General Situation Questionnaire includes 26 items, focusing on parturient's general situation, such as age, residence, educational level as well as antenatal care. Edinburgh Postnatal Depression Scale is preliminary screening standard for postpartum depression, which includes 10 contents and full 30 points. A positive screening is the score over 13.Based on these protective or risk factors found out by our screening study,300 voluntary lying-in mothers received comprehensive intervention measures from March 2009 to August 2009. The effect of the intervention measures was evaluated by Edinburgh Postnatal Depression Scale on day 42 after delivery. The measures include the private "one-to-one" communication between midwife and the patient; 5 collective interventions such as psychotherapy, prenatal education, role-experience, companied by husband.2 interventions have been performed after delivery, one is education in ward 3 days after delivery, another one is fellow-up by telephone 30 days after delivery.The data were analyzed using both univariate analysis and multi-variable Logistic analysis by SPSS software 11.5. Values of P< 0.05 was considered significant.Results:The screening rate of postpartum depression in our study was 18.13%. Place of residenc, unfavorable pregnancy case history, mood,health care, complications during pregnancy, love of family and health education in pregnancy as well as the preparation for parturition are the major factors significantly related to postpartum depression. Lover of family and preparation for parturition have protective role. Unfavorable pregnancy case history and job distribution have critical effect. The incidence of postpartum depression in experimental group is 13.41%, which is lower than control group does but no statistical significance.Among them, subjective wellbeing, health education in pregnancy, job distribution during pregnancy as well as the preparation for parturition are the most significant ones. However, our data showed that age of pregnant woman, income level, delivery pattern did not contribute to the incidence of this disease.Conclusion:1. The pathogenesis of postpartum depression is complicated; and multiple factors contribute to the development of the disease. Among them, subjective wellbeing, health education in pregnancy, job distribution during pregnancy as well as the preparation for parturition are the most significant related factors on incidence of PPD.2. In clinical practice, early intervention measure based on both protective and risk factors might reduce the incidence of this disease.