新生儿重症监护病房住院早产儿母亲产后抑郁与早期泌乳量的相关性
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摘要
目的:探讨新生儿重症监护病房(NICU)住院早产儿母亲产后抑郁与早期泌乳量的相关关系。方法:选取山东省某三级甲等综合医院122例NICU住院早产儿母亲为研究对象,采用现况调查法对研究对象在患儿住院期间的泌乳量进行连续跟踪测定。应用爱丁堡产后抑郁量表(EPDS)对其进行产后抑郁筛查,以EPDS得分≥10分为产后抑郁筛查阳性,将阳性者纳入产后抑郁筛查阳性组;EPDS得分<10分者纳入正常组,比较两组研究对象产后早期每日泌乳量及平均吸奶频率,并分析EPDS得分与泌乳量的相关性。结果:NICU住院早产儿母亲产后抑郁筛查阳性率为58%(58/100)。阳性组产后第11~14天泌乳量低于正常组(均P<0.05/14),平均吸奶频率也低于正常组(P<0.05)。EPDS得分与产后第2天及第11~14天泌乳量均呈负相关,相关系数在-0.38~-0.35之间(均P<0.05/14)。结论:本研究提示,NICU住院早产儿母亲产后抑郁筛查阳性率高,产后抑郁可能对其产后早期泌乳量产生不利影响。
Objective: To investigate the relationship between postpartum depression and the early milk volume among mothers of preterm infants in neonatal intensive care unit( NICU). Methods: Totally 122 mothers of preterm infants in NICU from one Grade-Ⅲ Class-A hospital in Shandong Province were invited to participate in the study. Continuous measurements for daily breast milk production were performed during the preterm infants ' hospitalization. The postpartum depression was screened with the Edinburgh Postnatal Depression Scale( EPDS). The EPDS score of more than 10 was considered positive for postpartum depression,which were dovetailed in postpartum depression positive group. The EPDS score < 10 was included in the normal group. The milk volumes and pumping frequencies were compared among two groups. The relationship between milk volume and EPDS scores was analyzed. Result:The positive rate of postpartum depression among preterm mothers was 58%( 58/100). The milk volumes were lower in positive group than in the normal group during day 11 to day 14 postpartum( Ps < 0. 05/14),the pumping frequen-cies were lower in positive group than in the normal group( P < 0. 05). The EPDS scores were negatively correlated with milk volume during day 2 and day 11 to day 14 postpartum( r =-0. 38--0. 35,Ps < 0. 05/14). Conclusion:The study shows that the positive rate of postpartum depression for the mothers of preterm infants in NICU is high. Postpartum depression may have a negative effect on milk production during early postpartum.
Objective: To investigate the relationship between postpartum depression and the early milk volume among mothers of preterm infants in neonatal intensive care unit( NICU). Methods: Totally 122 mothers of preterm infants in NICU from one Grade-Ⅲ Class-A hospital in Shandong Province were invited to participate in the study. Continuous measurements for daily breast milk production were performed during the preterm infants ' hospitalization. The postpartum depression was screened with the Edinburgh Postnatal Depression Scale( EPDS). The EPDS score of more than 10 was considered positive for postpartum depression,which were dovetailed in postpartum depression positive group. The EPDS score < 10 was included in the normal group. The milk volumes and pumping frequencies were compared among two groups. The relationship between milk volume and EPDS scores was analyzed. Result:The positive rate of postpartum depression among preterm mothers was 58%( 58/100). The milk volumes were lower in positive group than in the normal group during day 11 to day 14 postpartum( Ps < 0. 05/14),the pumping frequen-cies were lower in positive group than in the normal group( P < 0. 05). The EPDS scores were negatively correlated with milk volume during day 2 and day 11 to day 14 postpartum( r =-0. 38--0. 35,Ps < 0. 05/14). Conclusion:The study shows that the positive rate of postpartum depression for the mothers of preterm infants in NICU is high. Postpartum depression may have a negative effect on milk production during early postpartum.
引文
[1]张颖.479例妇女产后抑郁情况及社会心理影响因素分析研究[D/OL].武汉:华中科技大学,2011.(2012-04-26)[2017-8-4].http:∥www.wanfangdata.com.cn/details/detail.do?_type=degree&id=D186504.
[2]沈荣.产后抑郁现状和影响因素调查分析及其心理干预效果研究[D/OL].太原:山西医科大学,2011.(2011-11-30)[2017-8-4].http:∥www.wanfangdata.com.cn/details/detail.do?_type=degree&id=Y1948939.
[3]Yozwiak JA.Postpartum depression and adolescent mothers:a review of assessment and treatment approaches[J].J Pediatr Adolesc Gynecol,2010,23(3):172-178.
[4]何志毅.产母抑郁对母乳喂养的影响[J].实用妇产科杂志,2000,16(5):250-251.
[5]侯永梅,胡佩诚,张咏梅,等.产后抑郁对初产妇产褥期身心康复的影响[J].现代预防医学,2013,40(3):441-443,446.
[6]Fewtrell MS,Kennedy K,Ahluwalia JS,et al.Predictors of expressed breast milk volume in mothers expressing milk for their preterm infant[J].Arch Dis Child Fetal Neonatal Ed,2016,2(3):308-321.
[7]Murase M,Nommsen-Rivers L,Morrow AL,et al.Predictors of low milk volume among mothers who delivered preterm[J].J Hum Lact,2014,30(4):425-435.
[8]Héon M,Goulet C,Garofalo C,et al.Acceptability and feasibility of a breast milk expression education and support intervention in mothers of preterm infants[J].Adv Neonatal Care,2014,14(4):9-19.
[9]Lee DT,Yip SK,Chiu HF,et al.Detecting postnatal depression in Chinese women Validation of the Chinese version of the Edinburgh Postnatal Depression Scale[J].Br J Psychiatry,1998,172(5):433-437.
[10]世界卫生组织.母乳喂养咨询培训教程[M].北京:北京医科大学、中国协和医科大学联合出版社,1997:200-207.
[11]Nommsen-Rivers LA,Chantry CJ,Peerson JM,et al.Delayed onset of lactogenesis among first-time mothers is related to maternal obesity and factors associated with ineffective breastfeeding[J].Am J Clin Nutr,2010,92(3):574-584.
[12]钱耀荣,晏晓颖.中国产后抑郁发生率的系统分析[J].中国实用护理杂志,2013,29(12):1-3.
[13]Suhitharan T,Pham TP,Chen H,et al.Investigating analgesic and psychological factors associated with risk of postpartum depression development:a case-control study[J].Neuropsychiatr Dis Treat,2016,12(9):1333-1339.
[14]李成,于秀荣,吴玉梅等.新生儿重症监护病房住院早产儿母亲产后抑郁相关因素的研究[J].中国实用护理杂志,2015,31(16):1221-1224.
[15]吴艳.孕产妇围产期抑郁状况的调查及其相关因素的分析[D/OL].南京:东南大学,2010.(2010-12-22)[2017-8-4].http:∥www.wanfangdata.com.cn/details/detail.do?_type=degree&id=Y1753890.
[16]卢岩,高玲玲,王平,等.住院早产儿父母的心理需求及其影响因素研究[J].中华护理杂志,2005,40(4):247-250.
[17]原孟.241例早产相关因素及早产儿结局病例分析[D/OL].大连:大连医科大学,2014.(2014-11-06)[2017-8-4].http:∥www.wanfangdata.com.cn/details/detail.do?_type=degree&id=Y2587193.
[18]朱春香,赵缨,夏慧,等.早产儿母亲产后抑郁状况及其影响因素研究[J].中国实用护理杂志,2017,33(7):531-535.
[19]魏庆,张素云.妊娠期妇女心理状态相关研究进展[J].护理学报,2009,16(2):25-27.
[20]Yusuff AS,Tang L,Binns CW.Breastfeeding and postnatal depression:a prospective cohort study in Sabah,Malaysia[J].J Hum Lact,2016,32(2):277-281.
[21]宋修丽,焦志安.产后抑郁对乳汁分泌的影响[J].现代妇产科进展,2011,20(4):327-328.
[22]刘红蕾,丁蓉,贺红云.产后抑郁患者血清催乳素、孕酮水平的变化[J].南华大学学报(医学版),2010,38(4):534-536.
[23]江慎辉,肖爱兰.产后抑郁对母乳喂养的影响[J].山东精神医学,2005,18(3):142.
[24]陈琦,张建爱.产妇抑郁对泌乳与产后流血的影响[J].中国心理卫生杂志,2002,16(12):869-870.
[2]沈荣.产后抑郁现状和影响因素调查分析及其心理干预效果研究[D/OL].太原:山西医科大学,2011.(2011-11-30)[2017-8-4].http:∥www.wanfangdata.com.cn/details/detail.do?_type=degree&id=Y1948939.
[3]Yozwiak JA.Postpartum depression and adolescent mothers:a review of assessment and treatment approaches[J].J Pediatr Adolesc Gynecol,2010,23(3):172-178.
[4]何志毅.产母抑郁对母乳喂养的影响[J].实用妇产科杂志,2000,16(5):250-251.
[5]侯永梅,胡佩诚,张咏梅,等.产后抑郁对初产妇产褥期身心康复的影响[J].现代预防医学,2013,40(3):441-443,446.
[6]Fewtrell MS,Kennedy K,Ahluwalia JS,et al.Predictors of expressed breast milk volume in mothers expressing milk for their preterm infant[J].Arch Dis Child Fetal Neonatal Ed,2016,2(3):308-321.
[7]Murase M,Nommsen-Rivers L,Morrow AL,et al.Predictors of low milk volume among mothers who delivered preterm[J].J Hum Lact,2014,30(4):425-435.
[8]Héon M,Goulet C,Garofalo C,et al.Acceptability and feasibility of a breast milk expression education and support intervention in mothers of preterm infants[J].Adv Neonatal Care,2014,14(4):9-19.
[9]Lee DT,Yip SK,Chiu HF,et al.Detecting postnatal depression in Chinese women Validation of the Chinese version of the Edinburgh Postnatal Depression Scale[J].Br J Psychiatry,1998,172(5):433-437.
[10]世界卫生组织.母乳喂养咨询培训教程[M].北京:北京医科大学、中国协和医科大学联合出版社,1997:200-207.
[11]Nommsen-Rivers LA,Chantry CJ,Peerson JM,et al.Delayed onset of lactogenesis among first-time mothers is related to maternal obesity and factors associated with ineffective breastfeeding[J].Am J Clin Nutr,2010,92(3):574-584.
[12]钱耀荣,晏晓颖.中国产后抑郁发生率的系统分析[J].中国实用护理杂志,2013,29(12):1-3.
[13]Suhitharan T,Pham TP,Chen H,et al.Investigating analgesic and psychological factors associated with risk of postpartum depression development:a case-control study[J].Neuropsychiatr Dis Treat,2016,12(9):1333-1339.
[14]李成,于秀荣,吴玉梅等.新生儿重症监护病房住院早产儿母亲产后抑郁相关因素的研究[J].中国实用护理杂志,2015,31(16):1221-1224.
[15]吴艳.孕产妇围产期抑郁状况的调查及其相关因素的分析[D/OL].南京:东南大学,2010.(2010-12-22)[2017-8-4].http:∥www.wanfangdata.com.cn/details/detail.do?_type=degree&id=Y1753890.
[16]卢岩,高玲玲,王平,等.住院早产儿父母的心理需求及其影响因素研究[J].中华护理杂志,2005,40(4):247-250.
[17]原孟.241例早产相关因素及早产儿结局病例分析[D/OL].大连:大连医科大学,2014.(2014-11-06)[2017-8-4].http:∥www.wanfangdata.com.cn/details/detail.do?_type=degree&id=Y2587193.
[18]朱春香,赵缨,夏慧,等.早产儿母亲产后抑郁状况及其影响因素研究[J].中国实用护理杂志,2017,33(7):531-535.
[19]魏庆,张素云.妊娠期妇女心理状态相关研究进展[J].护理学报,2009,16(2):25-27.
[20]Yusuff AS,Tang L,Binns CW.Breastfeeding and postnatal depression:a prospective cohort study in Sabah,Malaysia[J].J Hum Lact,2016,32(2):277-281.
[21]宋修丽,焦志安.产后抑郁对乳汁分泌的影响[J].现代妇产科进展,2011,20(4):327-328.
[22]刘红蕾,丁蓉,贺红云.产后抑郁患者血清催乳素、孕酮水平的变化[J].南华大学学报(医学版),2010,38(4):534-536.
[23]江慎辉,肖爱兰.产后抑郁对母乳喂养的影响[J].山东精神医学,2005,18(3):142.
[24]陈琦,张建爱.产妇抑郁对泌乳与产后流血的影响[J].中国心理卫生杂志,2002,16(12):869-870.