Gender, poverty, and postnatal depression: A study of mothers in Goa, India
Gender, poverty, and postnatal depression: A study of mothers in Goa, India
复制标题
DOI：
10.1176/appi.ajp.159.1.43
复制
发表时间：
2002-01-01
影响因子：
17.7
通讯作者：
DeSouza, N
中科院分区：
文献类型：
--
作者：
Patel, V;Rodrigues, M;DeSouza, N
目的：本研究描述了一个低收入国家新近分娩的母亲抑郁的自然病史，并探讨风险因素，特别是与婴儿性别偏见相关的因素对抑郁症的发生和结局的影响。方法：作者研究了一组在妊娠晚期从印度果阿一家地区医院招募的孕妇。在招募、分娩后6-8周和6个月对这些母亲进行了访谈，访谈数据包括产前和产后抑郁症的存在、产科史、经济和人口统计学特征以及基于性别的变量（偏好男婴、是否存在婚姻暴力）。结果：分娩后6-8周，59例（23%）母亲出现抑郁障碍；这些患者中有78%在产前有临床上实质性的心理疾病。超过一半的患者在分娩后6个月仍然患病。经济贫困和婚姻关系不佳是抑郁症发生和慢性的重要危险因素。婴儿的性别是产后抑郁的一个决定因素，它修正了其他风险因素的影响，如婚姻暴力和饥饿。抑郁的母亲比没有抑郁的母亲更残疾，更有可能使用医疗服务。结论：作为低收入国家的优先事项，孕产妇和婴儿保健政策必须将孕产妇抑郁症作为一种具有公共卫生意义的疾病纳入其中。干预措施应以产前的母亲为目标，并纳入强有力的基于性别的内容。
Objective: This study described the natural history of depression in mothers who recently gave birth in a low-income country and to investigate the effect of risk factors, particularly related to infant gender bias, on the occurrence and outcome of depression.Method: The authors studied a group of pregnant mothers recruited during their third trimester of pregnancy from a district hospital in Goa, India. The mothers were interviewed at recruitment, 6-8 weeks, and 6 months after childbirth, interview data included presence of antenatal and postnatal depression, obstetric history, economic and demographic characteristics, and gender-based variables (preference for male infant, presence of marital violence).Results: Depressive disorder was detected in 59 (23%) of the mothers at 6-8 weeks after childbirth; 78% of these patients had had clinically substantial psychological morbidity during the antenatal period. More than one-half of the patients remained ill at 6 months after delivery. Economic deprivation and poor marital relationships were important risk factors for the occurrence and chronicity of depression. The gender of the infant was a determinant of postnatal depression it modified the effect of other risk factors, such as marital violence and hunger. Depressed mothers were more disabled and were more likely to use health services than nondepressed mothers.Conclusions: Maternal and infant health policies, a priority in low-income countries, must integrate maternal depression as a disorder of public health significance. Interventions should target mothers in the antenatal period and incorporate a strong gender-based component.