Physical health, breastfeeding problems and maternal mood in the early postpartum: a prospective cohort study
Physical health, breastfeeding problems and maternal mood in the early postpartum: a prospective cohort study
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DOI：
10.1007/s00737-017-0805-y
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发表时间：
2018-06-01
影响因子：
4.5
通讯作者：
Donath, S. M.
中科院分区：
文献类型：
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作者：
Cooklin, A. R.;Amir, L. H.;Donath, S. M.
本研究旨在前瞻性地探讨产后8周母体健康和/或母乳喂养问题对母体情绪(抑郁、焦虑、疲劳、易怒、困惑、活力)的影响。进行了一项前瞻性研究。参与者是从澳大利亚墨尔本的一家公立和一家私立妇产科医院招募的。未分娩孕妇(N=229)，年龄18岁，孕周36周，单胎妊娠，有足够的英语水平者均符合条件。采用问卷调查法(孕期、产后1~4周)和电话访谈法(产后8周)收集资料。高负担的身体问题被归类为>；=2个时间点的3个问题(剖腹产/会阴疼痛；背部疼痛；便秘；痔疮；尿失禁和大便失禁)。母乳喂养问题的高负担是在>；=2个时间点内有2个问题(乳房炎；乳头疼痛；频繁表达；乳汁供应过剩或不足)。采用多元线性回归方法研究母亲的情绪状况(产后8周)与高母乳喂养负担和/或身体健康问题之间的关系。46名妇女(20.1%)有高负担的身体症状，44名(19.2%)只有高负担的母乳喂养问题，25名妇女(11.0%)两者都有。母乳喂养问题的高负担(Beta=10.6，p=0.01)或同时存在的身体问题(Beta=15.35，p=0.002)与8周时母亲的情绪较差显著相关。对产妇健康和母乳喂养问题进行早期、有效的产后治疗可以降低妇女心理健康不良的风险。
This study aimed to investigate prospectively the contribution of maternal physical health and/or breastfeeding problems to maternal mood (depression, anxiety, fatigue, irritability, confusion, vigor) at 8-weeks postpartum. A prospective study was conducted. Participants were recruited antenatally from a public and a private maternity hospital in Melbourne, Australia. Nulliparous pregnant women (N = 229), >= 18 years of age, >= 36-week gestation, singleton pregnancy and with sufficient English were eligible. Data were collected by self-report questionnaire (pregnancy, weeks 1-4 postpartum) and telephone interview (week 8 postpartum). A high burden of physical problems was classified as >= 3 problems (caesarean/perineal pain; back pain; constipation; haemorrhoids; urinary and bowel incontinence) for >= 2 time points. A high burden of breastfeeding problems was having >= 2 problems (mastitis; nipple pain; frequent expressing; over-or under-supply of milk) for >= 2 time points. Multivariate linear regression was used to investigate the relationship between maternal mood, assessed using Profile of Mood States (8-week postpartum), and a high burden of breastfeeding and/or physical health problems. Forty-six women (20.1%) had a high burden of physical symptoms, 44 (19.2%) a high burden of breastfeeding problems only and 25 women (11.0%) had both. A high burden of breastfeeding problems alone (beta = 10.6, p = 0.01) or with co-morbid physical problems (beta = 15.35, p = 0.002) was significantly associated with poorer maternal mood at 8 weeks. Early, effective postnatal treatment of maternal health and breastfeeding problems could reduce women's risk for poor mental health.