Comprehensive Study Of Factors Of Postpartum Depression Occurs

ObjectiveThrough the analysis of the maternal questionnaire and prenatal, postpartum maternal endocrine hormone level change, understanding of postpartum depression(Postpartum depression PPD) incidence, found that prenatal psychological, social factors of postpartum depression and maternal 72 hours and 72 hours postpartum, postpartum 14 days, serum estradiol(E2), prolactin(PRL), progesterone(P), five hydroxytryptamine(5-HT) level changes and postpartum depression.Methods1.500 women were randomly selected in October 1 2013-2014 year in February in our hospital were included in this study. All women informed consent, volunteered to join this research, no no mental retardation, mental disorders, brain disease, endocrine disease and severe somatic diseases history. Gestational weeks 38.6 ± 2.5 weeks, at the age of 20 ~ 47 years old, the average age was 29.1 ± 2.15 years, occupation is not restricted, primary school degree or above, no need to help to understand the basic situation questionnaire and the Edinburgh depression scale content. On the third day postpartum, 500 independent of maternal or complete maternal general situation questionnaire under the guidance of a doctor(according to the research on China after the depression related factors such as the Lv Jun, contains 36 questions) and the Edinburgh Depression Scale(EPDS) to fill in, by a professional physician assessment of psychological health. Among the 495 valid, 112 patients with EPDS ≥ 13, 383 cases of EPDS < 13 points. 2.Randomly selected 30 cases of non depression group, depression group 30 cases, in laboratory studies. In pregnant women, postpartum 72 hours, 72 hours, 14 days morning fasting collected 5.0ml blood to blood, standing at room temperature. Centrifugal, separation of serum, 2 ℃~ 8 ℃storage. By radioimmunoassay and enzymelinked immunosorbent assay for serum estradiol, prolactin, progesterone, five hydroxytryptamine level comparisons. Measured data using SPSS20.0 statistical software for statistical analysis, all data were performed with the teenage boy distribution test, both the number of teenage boy distributed data(± s) said, the two groups were compared using t test, a =0.05 is a statistical test standard.Results1.Third days postpartum, 495 valid questionnaires, EPDS ≥ 13 were 112 cases, 383 cases of EPDS < 13, the incidence of postpartum depression was 22.62%. 2.Analysis of the index of single factor non conditional logistic regression, 36 of them: the living environment, marital status, the relationship between mother-in-law and daughter-in-law, postpartum depression related knowledge, have the relevant no pregnant women school, puerperal education, feeding knowledge 8 and postpartu-mm depression, with statistical significance(P, <0.05) analysis of multiple factor n-onconditional logistic regression: remarried, adverse pregnancy history, old woman daughter-in-law relation between risk factors, labor ready, postpartum depression in pr-enant women school education, as a protective factor. 3.In the determination of postpartum several important hormone levels, laboratory results as follows:(1)The depression group prenatal 72 hours estradiol level(243.34 ± 21.9 pg/ml)was higher than that in control group(235.81 ± 25.7 pg/ml), no significant differrence(P >0.05). In 72 hours after two groups of estradiol levels were decreased, postpartum 72 hours estradiol levels were compared, the depression group(101.14 ± 6.1 pg/ml) was significantly lower than the control group(156.54 ± 8.5 pg/ml), there was significant difference(P <0.05). 14 days postpartum depression group, estradiol level was(20.65 ± 5.6 pg/ml) was higher than that in control group(24.12 ± 12.4 pg/ml), but no significant difference(P >0.05).(2)The depression group prenatal prolactin levels for(305.28 ± 8.6 ng/ml) was significantly lower than the control group(364.78 ± 6.5 ng/ml), there was signifycant difference(P <0.05). 72 hours postpartum prolactin levels are compared, the depression group(344.87 ± 6.9 ng/ml) was lower than the control group(456.54 ± 15.5 ng/ml), there was significant difference(P <0.05). 14 days postpartum depression group, prolactin levels for(108.16 ± 7.4 ng/ml) was slightly lower than that of the control group(130.34 ± 11.1 ng/ml), through the analysis of the data showed no significant difference(P >0.05).(3)The level of progesterone group prenatal depression was(87.53 ± 42.4 μ IU/ml) was higher than that in control group(52.19 ± 21.3 μ IU/ml), no significant difference(P >0.05). 72 hours postpartum progesterone levels in the two groups are compared, the depression group(6.777 ± 1.12 μ IU/ml) higher than that of the control group(2.14 ± 1.15 μ IU/ml), there was significant difference(P <0.05). 14 days postpartum depression group, progesterone level was(1.83 ± 0.98 μ IU/ml) was higher than that in control group(1.45 ± 1.12 μ IU/ml), no significant differentce(P >0.05).(4)The depression group prenatal five hydroxytryptamine level(222.12 ± 44.4 pg/ml), control group(332.46 ± 13.2 pg/ml), the depression group than in the control group, there was statistically significant difference(P <0.05). Postpartum 72 hours five serotonin levels are compared, the depression group(190.13 ± 53.0 pg/ml) was lower than the control group(449.23 ± 81.5 pg/ml), there was significant difference(P <0.05). 14 days postpartum depression group, five levels of serotonin was(246.32 ± 19.8 pg/ml) was lower than the control group(425.23 ± 56.3 pg/ml), there was significant difference by data analysis(P <0.05).Conclusion1.Postpartum depression in the area occurred in 22.62%. 2.The living environment, marital status, the relationship between mother-in-law and daughter-in-law, postpartum depression related knowledge, have no pregnant women school, puerperal education, feeding knowledge 8 and postpartum depression. Remarriage, adverse pregnancy history, old woman daughter-in-law relation difference of risk factors, labor ready, postpartum depression, pregnant women school education were protective factors. 3.A drastic changes in the incidence of postpartum depression and postpartum maternal prenatal serum estradiol, prolactin, serum progesterone level, five levels of serotonin.