摘要
目的探讨产后抑郁症与血浆皮质醇、雌二醇及孕酮之间的关系。方法回顾性分析2014年3月至2016年1月,杭州师范大学附属医院收治的338例初产妇,在产后7d时,采用爱丁堡产后抑郁量表(EPDS)评分筛选产后抑郁症患者,定义为抑郁组,并在非产后抑郁产妇中随机挑选同等数量受试者,定义为非抑郁组。统计产后抑郁发生率,比较产后抑郁组与非抑郁组的临床资料,产前、产后2d、产后7d皮质醇、雌二醇及孕酮的差异,最后探讨产后抑郁症与皮质醇、雌二醇、孕酮等指标间的相关性。计量资料的比较采用t检验,计数资料的比较采用χ~2检验,两因素相关采用pearson相关,产后抑郁症的多因素分析采用多元线性回归分析。结果在338例受试者中,检测出产后抑郁症患者42例,产后抑郁症的发生率为12.43%。产后抑郁组和非抑郁组文化程度的差异有统计学意义(P<0.05)。产前,两组患者皮质醇、雌二酮、孕酮水平差异均无统计学意义(P>0.05);产后2d,两组雌二酮、孕酮的差异有统计学意义(P<0.05),而皮质醇的差异无统计学意义(P>0.05);产后7d,两组间皮质醇、雌二醇、孕酮的差异均有统计学意义(P<0.05)。Pearson相关分析显示,产后EPDS评分与产后2d雌二醇及7d雌二醇呈负相关(r=-0.693、-0.591,P<0.01),与产后2d孕酮、7d孕酮、7d皮质醇呈正相关(r=0.734、0.366、0.324,P<0.01),logistic回归分析显示,产后抑郁与产后2d雌二醇、产后2d孕酮及产后7d雌二醇相关(P<0.05)。结论产后雌二醇水平下降过快,或孕酮维持较高水平是产后抑郁发生的危险因素,检测产后2d时的雌二醇及孕酮水平对于预测产后抑郁症的发生有重要意义。
Objective To explore the correlation between postpartum depression and blood levels of cortisol, estradiol and progesterone. Methods A total of 338 pregnant women were followed up. The Edinburgh Postnatal Depression Scale （EPDS） was used for the screening of postpartum depression 7 days after birth. Meanwhile, an equal number of women with no postpartum depression were randomly selected as con- trois. The incidence of postpartum depression was calculated. The cortisol, estradiol and progesterone levels in blood samples were determined and compared before birth, 2 days and 7 days a{ter delivery. Student t test, chi- square test and multi factor line regression method were used for the data statistical analysis. Results Out of 338 subjects, 42 were diagnosed with postpartum depression with the incidence of 12.430~. The differences of education and estradiol and progesterone levels of two days after birth were all statistically significant between pregnant women with and without postpartum depression （P〈0. 05） . There were no significant differences of serum levels of cortisol, estradiol and progesterone before birth and cortisol level of 2 days after birth between 2 groups （P〉0.05）. However, the differences of serum levels of cortisol, estradiol and progesterone were all statistically significant 7 days after birth （P〈0.05）. Pearson correlation analysis showed that, postnatal EPDS score was negatively correlated with estradiol level of 2 days and 7 days after birth （r=-0. 693, -0. 591, P 〈0.01）, while positively correlated with progesterone levels of 2 days and 7 days after birth, as well as eorti- sol level of 7 days after birth （r=0. 734, 0. 366, 0. 324, P〈0.01）. Logistic regression analysis showed that estradiol levels of 2 days and 7 days after birth and progesterone level of 7 days after birth were risk factors for postpartum depression （P〈0. 05）. Conclusions Large margin decline of estradiol or high levels of proges- terone may be risk factors for postpartum depression;
出处
《中国预防医学杂志》
CAS
CSCD
2017年第4期286-289,共4页
Chinese Preventive Medicine
关键词
产后抑郁症
皮质醇
雌二醇
孕酮
Postpartum depression
Cortisol
Estradiol
Progesterone
