付英杰　　王贺　　高晓岩　　渠晶　　刘丹丹

[關键词] 围产期;抑郁筛查;综合干预;爱丁堡产后抑郁量表

[中图分类号] R749.4          [文献标识码] A          [文章编号] 1673-9701（2021）14-0027-05

Research on the perinatal depression screening and comprehensive intervention in Harbin

FU Yingjie   WANG He   GAO Xiaoyan   QU Jing   LIU Dandan

Department of Women Health Care， Harbin Maternal and Child Care Family Planning Service Center， Harbin 150000， China

[Abstract] Objective To research the efficacy of perinatal depression screening and comprehensive intervention. Methods A total of 496 women who underwent regular prenatal examination in Harbin Maternal and Child Care Family Planning Service Center from January to December 2019 were selected and screened for depression assessment by Edinburgh postnatal depression scale （EPDS）. The screened 122 women with different degrees of depression were randomly divided into the study group and the control group， with 61 cases in each group. The control group was treated with general intervention， while the study group was treated with comprehensive intervention. The depression， univariate and bivariate analysis， depression score and intervention efficacy indexes were compared between the two groups of patients. Results The results of depression screening of 496 pregnant women included 113 patients with mild to moderate depression and 9 patients with severe depression; Age， marital times， educational level， relationship between husband and wife， whether to plan pregnancy， awareness of health care knowledge during pregnancy， occurrence of negative events during pregnancy， and degree of gender compliance with expectations were all single impacting factors of patients with perinatal depression， with significant differences（P<0.05）. Multivariate Logistic regression analysis showed that unplanned pregnancy， inconsistent gender expectations， occurrence of negative events during pregnancy， average relationship between husband and wife， and poor awareness of health care knowledge during pregnancy were the risk factors impacting patients with perinatal depression， with significant differences（P<0.05）. After intervention， the depression scores of pregnant women in the study group were significantly lower than those in the control group， with significant differences（P<0.05）. Meanwhile， the total effective rate in the study group was significantly higher than that in the control group， with significant differences（P<0.05）. Conclusion It is necessary to screen the perinatal depression of women， and the efficacy of comprehensive intervention on depressed women is very obvious， which can effectively reduce the perinatal depression symptoms of pregnant women， and is worthy of promotion and application.

[Key words] Perinatal period; Screening for depression; Comprehensive intervention; Edinburgh postnatal depression scale

圍产期抑郁（Perinatal depression，PND）是指孕产妇自妊娠期至产后1年内发生的非精神病性抑郁障碍，包括产前和产后抑郁，具体表现为郁闷、悲伤、愤怒、焦虑、激动、烦躁、自卑、沮丧等临床表现，严重者可产生绝望、幻觉或自杀意念等精神症状[1]。有研究显示，PND在发达国家的发生率为11.4%，在发展中国家的发生率为13.1%，在我国的发生率为17.4%，且处于上升趋势，而且我国有32%～57%的PND未经发现或未引起重视。PND的发生不仅影响孕产妇的生活质量、婚姻关系和社会功能状态，还会影响婴幼儿的情绪、智力、认知和行为等正常发育，严重者甚至出现自杀或杀婴行为。为此，对围产期抑郁进行筛查并实施综合性干预，以降低孕产妇围产期抑郁发病率就显得尤为重要。本研究分析了围产期抑郁筛查及综合干预，现报道如下。

1 资料与方法

1.1 一般资料

选取2019年1—12月在我中心产科门诊规律产检和建档的有妊娠期抑郁症状496例孕妇作为研究对象。纳入标准[2]：①无精神病既往史或家族史;②未使用可影响精神活动的药物;③孕龄6～41周，年龄、妊娠、分娩次数不限;④符合妊娠期抑郁症筛查标准;⑤爱丁堡产后抑郁量表（Edinburgh postpartum depression scale，EPDS）评分≥13分;⑥有一定的文化素养（初中或以上），能理解量表内容并自愿参加本研究;⑦孕妇自己填写爱丁堡产后抑郁量表（EPDS）和一般个人情况量表，资料准确、真实。排除标准[3]：①存在严重心、肝、肾等重要器官疾病者;②存在严重的意识障碍者;③存在免疫、血液等慢性疾病者;④中途退出研究者。……