Research Of Autonomic Nervous System Function And Psychological State In Patients With Postpartum Depression During Pregnancy

Objective: To investigate the relationship between postpartum depression, autonomic nervous function and its psychological state. To determine which methods provided more effective and reliable scientific basis for the early prediction of postpartum depression.Methods: A prospective study of 250 maternal who established health care-card in our hospital from September 2014 to June 2015. The survey included early pregnancy instrument checks, general questionnaire and self-rating depression scale(SDS) / self-rating anxiety scale(SAS) questionnaire. Evaluating the result during childbirth and a questionnaire survey with the Edinburgh postnatal depression scale(EPDS) after 42 days postpartum follow-up. According to maternal EPDS score, subjects were divided into the postpartum depression group(EPDS≥13) and the normal control group(EPDS<13). The relationship among postpartum depression and socio-demographic characteristics, general characteristics, perinatal period characteristics, autonomic nerve function tests, psychological health self-assessment, and the correlation of antenatal psychological state and autonomic nerve function and the postpartum depression were investigated by using SPSS 22.0 statistical software for data analysis.Results:(1) During the first check-up of early pregnancy, 250 copies of questionnaires were handed out, in which 211 were effic ient and its efficiency is about 84.4%;(2) In our study, the occurrence of postpartum depression was 13.3%;(3) No significant differences were found between postpartum depression group and normal control group in socio-demographic factors( P > 0.05); the general characteristics and perinatal period characteristics were not statistically significant as well(P>0.05); the incidence of fear for delivery and premature delivery in postpartum depression group were obviously higher than normal control group, and the differences were statistically significant(P > 0.05);(4) Autonomic nervous system function in SDNN, LF/HF, differential pulse index and stroke volume in postpartum depression group were lower than normal control group, pressure index and the residual blood volume in postpartum depression group obviously higher than normal control group, and the differences were statistically significant(P < 0.05);(5) The early SAS and SDS scores in postpartum depression group obviously higher than that in normal control group, and the differences were statistically significant(P < 0.05);(6) It has positive correlation between the SAS/SDS score, pressure index, the residual blood and EPDS score; and negative correlation between SDNN, differential pulse index, stroke output and EPDS scores(P < 0.05), the LF/HF ratio and EPDS score have no correlation(P > 0.05).Conclusions:(1) The occurrence of postpartum depression was 13.3%, which is still within a normal range. But it should be noted that a lot of patients with postpartum depression were not diagnosed early because of variety of external factors;(2) Autonomic nervous function monitoring and early SDS/SAS results in postpartum depression group and normal control group had obvious difference. Therefore, using instruments to evaluate autonomic nervous function and psychological status of early pregnant women could provide strong evidence to early prediction and intervention of postpartum depression.