The Development Of Postpartum Depression In Patients With Preeclampsia

Background: Preeclampsia is one of the most common and serious complications in obstetrics.It is caused by multiple factors and mechanisms,involving inflammation,immunity,nutrition and genetic material.It mainly manifests as blood pressure elevation and multiple organ dysfunction.Postpartum depression is also a common obstetric disease caused by multiple factors,including psychological factors,obstetric factors,and biological factors and so on.However,since both diseases are common in obstetrics,whether preeclampsia increases the incidence of postpartum depression remains unclear and needs to be further explored.The purpose of our study is to 1)determine whether preeclampsia is a risk factor for postpartum depression,2)identify whether the incidence of postpartum depression is associated with the severity of preeclampsia.Objectives: We chose women who delivered in the First Affiliated Hospital of Chongqing Medical University between January 1,2017,and August 30,2018.Inclusion criteria: 1.diagnosed with preeclampsia according to the diagnostic criteria of clinical guidelines for pregnancy-induced hypertension issued by the American College ofObstetricians and Gynecologists in 2013,or normal and healthy puerperant and being the control group;2.age range from 20 to 40 years old;3.neonatal survival without deformity;4.gestational weeks ≥28 weeks.Exclusion criteria: 1.have other obstetric complications except preeclampsia;2.have a history of mental illness or postpartum depression,or immediate relatives has mental illness;3.lethal induction of labor or stillbirthMethods: We used a questionnaire survey to investigate the basic data and depression scores of parturient women about 6 weeks after delivery.The basic information include age,gestational weeks,BMI before delivery,gravidity,parity,mode of delivery,neonatal weight,premature birth rate,blood pressure,clinical symptoms,whether taking antihypertensive drugs and so on.The Edinburgh Postpartum Depression Scale was used to test the mental status,and a total score≥10 was identified as a positive outcome for postpartum depression screeningResults: A total of 180 parturient women,including 90 patients with preeclampsia and 90 healthy women,participated in our research.Among them,35 were positive for postpartum depression screening and the remaining 145 were negative.The incidence of postpartum depression in patients with preeclampsia was 26.67%(24/90),more than twice that of normal parturient women(12.22%).multiple logistic regressions showed that patients with preeclampsia had about 3-fold increased odds of postpartum depression.And the odds were positively correlated with theseverity of preeclampsia.In severe preeclampsia,the risk of postpartum depression increased more than 4-fold.Conclusion: Preeclampsia is an independent risk factor for postpartum depression.And more importantly,the incidence of postpartum depression is positively related to the severity of preeclampsia.Therefore,families,society and hospitals should attach great importance to it,and provide additional prevention and supportive treatment for patients with preeclampsia.Finally,we hope to achieve the goal of early screening,early prevention and early treatment of postpartum depression to reduce the incidence of postpartum depression and alleviate the clinical symptoms of postpartum depression.