Observational Study On Females’ Depression From Pregnancy To Postpartum And Immigrant Females’Postpartum Depression In Wuhan City

Objective:To examine the occurrence of depression in urban women from pregnancy to postpartum in Wuhan, China, and the dynamic features of the prevalence of depression in these women in order to identify the key factors influencing the occurrence and aggravation of depression in city-dwelling women during pregnancy and postpartum. To examine the prevalence of postpartum depression in rural-to-urban migrant women in Wuhan and further identigy the risk factors and protective factors of postpartum depression (PPD). To compare the prevalence of depression and the influencing factors between the urban women and the migrant women.Methods:(1) Longitudinal study. The urban women in Wuhan who were eligible for the study were enrolled. Baseline survey was performed and the depression symptoms were evaluated at early pregnancy. Door-to-door survey was then conducted by community doctors in these women at middle and late pregnancy and at1and3months after delivery. The subjects were required to fill out questionnaires at each visit and evaluated for their depression symptoms by using Edinburgh Postnatal Depression Scale (EPDS).(2) Cross-sectional study. The rural-to-urban migrant postpartum women who were eligible for the study were examined for their mental status by using the EPDS. A self-reported questionnaire was used for these women as well. Results:(1) During the whole pregnancy and delivery period, the detection rate of depression in urban women in Wuhan was dynamically changed and showed a certain pattern. It was increased with the gestation weeks, maintaining a relatively high level1and3month(s) after delivery. The EPDS scores presented a "U" pattern, significantly decreasing from1month to3months after delivery.(2) Logistic regression analysis showed that the influencing factors of depression at early pregnancy included dissatisfaction with the diet in the pregnancy, and negative life events. The influencing factor at the middle pregnancy was negative life events. Those at late pregnancy consisted of dissatisfaction with the care from the family and negative life events. Those at one month postpartum were low satisfaction with the husband’s care, low satisfaction with the living condition, low satisfaction with the recovery of the body shape, and negative life events. Those at3months postpartum included low satisfaction with the husband’s care, impulse of venting their feelings to babies, apprehension of the economic condition of the family.(3) The prevalence of depression in the rural-to-urban migrant women in Wuhan was high. The detection rate of PPD and the EPDS scores were significantly higher in these women than their city counterparts. Multiple Logistic regression analysis showed that the risk factors of depression in this population included no medical insurance, tired of taking care of babies, little or no care from their husband, dissatisfaction with the dwelling condition and distress events in their life.Conclusion:(1) The detection rate of depression in Wuhan women during pregnancy was increased with the gestation weeks. The rate of PPD retained high.(2) The EPDS scores presented a "U" pattern, significantly decreasing with the rest time after the delivery.(3)The depression symptoms were alleviated after the delivery and the PPD level was significantly decreased, which suggested that the depression in Wuhan women can self-recover to some extent.(4) The detection rate of depression and the depression level in the migrant women were high, significantly higher than the local women in Wuhan. The risk factors of depression in this population included no medical insurance, lack of meticulous care of husband, dissatisfaction with the dwelling condition, and negative life events after the delivery.