目的 探讨心理干预对产褥期抑郁症(postpartum depression,PPD)预防的效果。方法 选择在医院进行产前检查并住院分娩的孕产妇300例,分为两组,每组150例,观察组在孕28～40周自愿接受健康促进、心理咨询、产前心理疏导,并进行预防抑郁相关知识教育的心理干预,有完整资料;对照组仅接受孕产期常规检查及宣教,未进行预防性心理干预。采用美国精神病学会《精神疾病的诊断与统计手册》中PPD的诊断标准和爱丁堡产后抑郁量表(edinburgh postpartum depression scoring system,EPDS)进行PPD诊断,同时对产妇进行问卷调查,对各项相关因素进行分析。结果 PPD发病率观察组为0.67%,低于对照组的5.33%(8/150),两组相比差异有统计学意义(P<0. 05)。观察组产妇的孕期并发症、分娩并发症、夫妻关系、产前心理准备、分娩方式、抑郁相关知识知晓程度、分娩恐怖感等方面与对照组比较,差异有统计学意义(P<0.05)。结论 孕期心理干预能够降低PPD发生的高危因素,从而达到早期预防PPD发病的效果。

Objective To explore the preventive effect of psychological intervention during pregnancy on postpartum depression (PPD).Methods Three hundred pregnant women who received prenatal care and delivered in our hospital were selected. The observation group(150 cases) received general pregnancy health care plus volunteer psychological intervention, involving health promotion, psychological counseling, prenatal psychological guidance and knowledge related to the prevention of depression during the 28-40 weeks of pregnancy. All these cases had complete information. The control group(150 cases) was given general pregnancy health care without psychological intervention.All the subjects were assessed with the American Psychiatric Association(APA) Manual on Diagnosis and Statistics of Mental Illness,and the Edinburgh postpartum depression scoring system(EPDS).Meanwhile,a self-designed questionnaire survey was conducted among puerperas before statistical analysis was finished.Results The incidence of PPD (0.67%)in the observation group was lower than that of control group(5.33%).There was statistically significant difference between the two groups(P<0.05). The case was the same with maternal complications, childbirth complications, conjugal relationships, prenatal psychological preparation, delivery mode, depression-related knowledge, and fear of childbirth (P<0.05).Conclusions Psychological interventions during pregnancy can reduce the risk factors for PPD so that early prevention of the onset of PPD is possible.