Birth events, birth experiences and social differences in postnatal depression.
Birth events, birth experiences and social differences in postnatal depression.
复制标题
出生事件、出生经历和产后抑郁症的社会差异。
DOI：
--
复制
发表时间：
2010
期刊：
影响因子：
--
通讯作者：
R. Small
中科院分区：
文献类型：
--
作者：
J. Astbury;S. Brown;J. Lumley;R. Small
1989年，一项针对维多利亚州所有在一周内分娩的妇女的邮寄调查被用来评估出生事件、对护理的满意度和社会差异对出生后抑郁的影响。调查问卷在出生后8至9个月邮寄给女性。调查的回复率为71.4%(790/1107)，年轻妇女、单身妇女和非英语背景妇女的比例偏低。抑郁的评估使用爱丁堡产后抑郁量表，得分在13分或更高表示可能的临床抑郁症。抑郁的患病率为15.4%(95%的可信区间为12.8至18.0)。在最终的Logistic模型中，有两个因素与较低的抑郁几率相关：非大都市居住地和母亲年龄超过34岁。在模型中，与抑郁几率增加相关的因素包括34岁以上有第一个孩子、辅助分娩(剖腹产、产钳、真空拔牙)、奶瓶喂养、对产前护理不满意、分娩时有不受欢迎的人在场，以及在出院时缺乏照顾婴儿的信心。当考虑到这些因素时，未婚、出生在海外的非英语背景、对分娩和出生后的护理不满意，以及在决策中没有积极的发言权--在单变量分析中，所有这些都与抑郁症显著相关--都没有对模型做出任何额外的贡献。
A postal survey of all women who gave birth in Victoria in one week in 1989 was used to assess the contribution of birth events, satisfaction with care and social differences to depression after birth. The questionnaire was mailed to women eight to nine months after birth. The survey response was 71.4 per cent (790/1107) with underrepresentation of young women, single women and women of non-English-speaking background. Assessment of depression was made using the Edinburgh Postnatal Depression Scale, with a score of 13 or more indicating probable clinical depression. The point prevalence of depression was 15.4 per cent (95 per cent confidence interval 12.8 to 18.0). In the final logistic model two factors were associated with lower odds of depression: nonmetropolitan residence and maternal age over 34. Factors associated with increased odds of depression in the model were having a first child over the age of 34, assisted delivery (caesarean, forceps, vacuum extraction), bottle feeding, dissatisfaction with antenatal care, having unwanted people present at the birth and lacking confidence to look after the baby at the time of leaving hospital. When those factors were taken into account, being unmarried, being born overseas of non-English-speaking background, being dissatisfied with care in labour and after birth, and not having an active say in decision making, all of which were significantly associated with depression in univariate analyses, did not make any additional contribution to the model.