Preparation and Patient Education to Reduce Postpartum Depressive Symptoms

产妇抑郁症状与产妇生活质量下降、功能下降、婴儿住院率增加、母乳喂养减少、母亲较少参与重要发育行为（如说话和玩耍）以及产妇吸烟和饮酒增加有关。最近的研究已经开始检查产后早期的环境设置，并确定产后抑郁症状的潜在可改变的决定因素。情境因素如身体症状的痛苦、婴儿绞痛和缺乏社会支持是产后抑郁症状的触发因素，而社会支持和母亲管理情境压力的有效性可以缓冲抑郁反应。我们开发并试点测试了一种干预措施，通过准备和教育妇女抑郁症症状的具体情境触发因素，通过加强个人和社会资源，通过提高自我管理技能来缓冲产后需求，以及通过增加产后母亲获得现有医疗保健和社区资源的机会，来减少产后母亲的抑郁症状。我们从NCMHD获得资金，进行一项随机对照研究，在黑人和西班牙裔母亲中测试这种干预措施。拟议的研究将把来自所有种族/民族背景的妇女纳入该试验。这在两年内是可行的，因为西奈山的运送量很大。将雇用两名工作人员来应付增加的病人流量。

Maternal depressive symptoms are associated with reduced maternal quality of life, decreased ability to function, increased infant hospitalizations, reduced breastfeeding, less involvement of mothers with important developmental behaviors such as talking and playing, and increased maternal smoking and alcohol use. Recent studies have begun to examine the contextual setting of the early postpartum period and identify potentially modifiable determinants of postpartum depressive symptoms. Situational factors such as distress from physical symptoms, infant colic, and lack of social support are triggers for postpartum depressive symptoms while social support and mother's efficacy in managing situational stress buffer depressive reactions. We developed and pilot tested an intervention to reduce depressive symptoms in postpartum mothers by preparing and educating women about specific situational triggers of depressive symptoms, by bolstering personal and social resources, by enhancing self-management skills to buffer postpartum demands, and by increasing access to existing healthcare and community resources available to postpartum mothers. We obtained funding from NCMHD to conduct a randomized controlled study to test this intervention in Black and Hispanic mothers. The proposed study will add to this trial women from all racial/ethnic backgrounds. This is feasible within a two year time because of the large volume of deliveries at Mt. Sinai. Two staff members will be hired to accommodate this increased patient flow.