Investigation And Analysis Of Postpartum Depression Status And Its Influence Factors And Psychological Intervention Research

Objective1. To investigate the prevalence of Postpartum Depression of parturient woman. To analyse related factors which influence Postpartum Depression.2. To discuss the effectiveness of a psychological intervention from pregnancy to postpartum in reducing the incidenceof Postpartum Depression. Analyse psychological intervention effec, Providing guidance for further clinical psychological intervention.Methods1. We recruite study subjects from February 2010 to September 2010 402 parturient woman from the General Hospital of a Coal and Electrical Group Co.Ltd. All eligible parturient women who consented to participate were recruited into the study. And all of them were investigated by questionnaire. Contents in the questionnaire were the physical data, using scores on the HAD as indicators of anxiety and depressions symptoms for prenatal stage, measured their situation of social support by Social Support Rating Scale(SSRS). The Chinese version of the Edinburgh Postnatal Depression Scale(EPDS) was used in 1 week after delivery to assess PPD, with the total score of EPDS≥13 point as the cut-off for PPD. Who are in accordance with the DSM—IV diagnostic criteria for Postpartum Deression. Conduct investigation and analysis the relevant factors which influence Postpartum Depression.2. From December 2010 to January 2011 104 nulliparas in the obstetrical department of the general hospital were selected. 104 cases of primiparas consisting with the entering standard were randomly as signed into two groups. Participants completed questionnaires. One group of 52 cases of psychological intervention (the intervention group), another group of 52 cases of the control group. Intervention group is given a psychological intervention from pregnancy to postpartum, psychological intervention measures including cognitive therapy, psychological support therapy, behavioral therapy and so on; while, there is no any measures for the control group. Both group were assessed by EPDS in 1 week after delivery, and the results of which were analyzed statistically.Statistical analysis Software Package of SPSS(versionl3.0)was used in all analysis, in-cluding descriptive analysis, Chi-square test, t test, simple and multiple factors non-conditional logistic regression analysis.Results 1. In this study completed records were obtained on 402 women, yielding a completion rate of 98.05%. Four hundred and ten subjects were recruited into the study, the number of Postpartum Depression is 82, The rate of prevalence of Postpartum Depression is 20.4%.2. The education level, occupation, housing conditions, the gender of the newborn had difference between postpartum depression group and non-postpartum depression group(P<0.05). according to the simple and multiple factors non-condition logistic regression analysis. The risk factors of Postpartum Depression were education level, occupation, housing conditions, the gender of the newborn, the status of medical workers, the early sucking and contact between mother and infant and so on.3. Emergence of the Postpartum Depression and antenatal psychological health status had obvious dependence. Among them, the antenatal pesrons who have emotion of anxiety and depression are 28.86%, there is 53.4% Postpartum Depression is take place. Emotion of anxiety and depression had significant influence on Postpartum Depression(χ2=109.687, P<0.001).4. The total society supports score of postpartum depression group, the score of subjective support and objective support, the availability of support were lower than the normal group(P< 0.01). The relationship among the total score of society supports, various dimensions and postpartum depression is remarkable inverse correlation. The social support significantly influenced postpartum depression. The subjetive social support and availability of support had significant influence on the occurrence of Postpartum Depression.5. According to the results of seals and questionnaires, the intervention group has no difference from the control group in the same stage. After psychological intervention from pregnancy to postpartum, the EPDS scores between two groups are significantly different in 1 week after delivery. EPDS scores of subjects in intervention group, with an incidence rate of postpartum depression being 3.8%, was significantly lower than those of control group (9.42±1.76 to 11.84±2.49, t=5.604, P<0.001), with the rate 21.2%, and a notable difference was found between the two groups according to statistics(χ2=7.121, P<0.01).Conclusions1. The rateof prevalence of Postpartum Depression is 20.4%, showing Postpartum Depression in parturient women have a higher prevalence rate. It is common disease and frequently occurring disease.2. Postpartum Depression is a result of the comprehensive function of many kinds of factors. The risk factor include without occupation, poor housing conditions, women giving birth to a female infant, and bad attitude of medical workers. The protect factor include high education level, the early sucking and contact between mother and infant and so on.3. Emotion of anxiety and depression of pregnant and parturient women who had no postpartum depression was significant different from pregnant and parturient women who had postpartum depression. There were positive correlation between the emotion of anxiety and depression and Postpartum Depression. Emotion of anxiety and depression of pregnant and parturient women is a significance prediction factor of the posptartum depression.4. Postpartum Depression women is short of the objective social support, the subjective socia support and the availability of support than normal, lower or lack of social support is a risk factor of PPD. The subjetive social support and availability of support have the remarkable forecast function to Postpartum Depression.5. Postpartum Depression needs our medical workers special attention as it can have severe consequences not only for the mother, but also for the infant and the whole family.6. This study shows that psychological intervention may improve the emotion of anxiety and depression of primipara and effectively decreases the incidence of postpartum depression.