The Status And Influencing Factors Of Perinatal Depression Among Husband And Wives Under Second Child Policy

Background:The incidence of depression in perinatal husbands and wives is high,and varies greatly in different regions and populations.Perinatal depression of second-child couples was less a problem in China in the past,and husbands’ perinatal depression has been less noticed.Previous studies have shown that perinatal depression persists steadily and changes mildly during pregnancy and delivery,and perinatal depression for couples appears most frequently in the third trimester of pregnancy and postpartum period.However,we find studies on the long term change of perinatal depression in China scarce.In addition,in the context of China’s two-child policy,the prevalence and influencing factors of perinatal depression may differ from the past,thus needs to be further studied.Also,the influence of family function on perinatal depression remains to be clarified.Objectives:(1)To describe the prevalence,trend,correlation of perinatal depression in first-time and experienced couples.(2)To explore the influencing factors of perinatal depression in first-time and experienced couples.(3)To analyze the status quo of family function in the couple’s third trimester of pregnancy and how it influenced each others’ perinatal depression.Methods:From January 2019 to February 2020,603 pregnant women and 289 husbands in the obstetrics department of Peking Union Medical College Hospital were recruited into our study,of whom 285 were couples.After delivery,466 wives and 203 husbands participated in the postpartum follow-up,and 203 couples were all paired data.A total of 185 couples participated in our study during the whole perinatal period.General information questionnaire,Family Assessment Device and Edinburgh Postnatal Depression Scale were used for data collection and evaluation.SPSS 25,0 and Mplus8.0 were used for statistical analysis.Results:(1)A total of 28.45%of pregnant women had antenatal depression in the third trimester of pregnancy,no statistical differences were found between the first-time and experienced wives.34.06%of them had postpartum depression in the 40-60 days after delivery,no statistical differences were found between the first-time and second-time new mothers.Depression was found in 19.06%of men in the third trimester of pregnancy,and decreased to 7.58%postpartum.No statistical differences were found between first-time and experienced new fathers.First-time mothers’depression score decreased slightly and second-child mothers’ score increased slightly postpartum."Husband has someone trustworthy to talk to" had a persistent effect on maternal perinatal depression.Husbands’ depression score decreased after delivery,and the decline was even greater for the second-child husbands.Wife’s number of diseases,whether there are birth complications and family function had a long lasting effect on husband’s perinatal depression.(2)Wife’s perinatal depression is relatively stable overtime,and has a positive correlation with husband’s postpartum depression,indicating that wife’s antepartum depression could cause husband’s postpartum depression.(3)Generalized linear model analysis showed that the influencing factors of perinatal depression is quite different between first-child and second-child couples.Family function in the third trimester of pregnancy influences greatly on the depression levels of couples.Age,whether or not the interviewee has someone trustworthy to talk to,influences wives’ perinatal depression score,and economic status,breast-feeding status and who look after wives after delivery influence husbands’ perinatal depression score.(4)Second-child couples’ family function is worse than first-child couples.Husband’s General Functioning,Problem Solving and Communication score influence wife’s perinatal depression.And wife’s Roles,Affective Responsiveness,Affective Involvement and Behavioral Control influence husband’s perinatal depression.Conclusions:(1)Wives’ perinatal depression score remains high and stable before and after delivery.First-time mother’s depression score decreased slightly after delivery,while second-time mother’s score increased slightly.Husband’s perinatal depression rate is lower than that of wife’s,and the score decreased significantly with the end of childbirth.No significant differences were found in first-child and second-child couple’s perinatal depression score.(2)Wife’s prenatal depression can cause husband’s postpartum depression level to increase.(3)First-child and second-child couple’s perinatal depression have quite different influencing factors.Second-child couples have worse family function,and different dimensions of family function are closely related to couple’s depression level.