卢旺达围生期抑郁和焦虑症状的流行情况及相关因素的横断面研究。
A cross-sectional study of the prevalence and factors associated with symptoms of perinatal depression and anxiety in Rwanda.
机构信息
School of Nursing, College of Medicine and Health Sciences, University of Rwanda, 3286, Kigali, Rwanda.
Department of Psychology, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
出版信息
BMC Pregnancy Childbirth. 2020 Jan 31;20(1):68. doi: 10.1186/s12884-020-2747-z.
BACKGROUND
Perinatal depression and anxiety are increasingly recognized as important public health issues in low and middle-income countries such as Rwanda and may have negative consequences for both mothers and their infants. Maternal mental health may be particularly challenged in Rwanda because of the prevalence of risk factors such as poverty, low education levels, negative life events and marital problems. However, there are limited data about perinatal depression and anxiety symptoms in Rwanda. This study thus aimed to explore the prevalence of symptoms of perinatal depression and anxiety in Rwanda, and factors associated with them.
METHODS
A sample of 165 women in the perinatal period (second and third trimester of pregnancy, up to 1 year postnatal) were interviewed individually over 1 month in October 2013. Women were interviewed at 5 of 14 health centres in the Eastern Province or the affiliated district hospital. Participants answered socio-demographic questions and scales measuring symptoms of perinatal depression (EPDS: Edinburgh Postnatal Depression Scale) and anxiety (SAS: Zung Self-rating Anxiety Scale).
RESULTS
Among women in the antenatal period (N = 85), 37.6% had symptoms indicating possible depression (EPDS ≥10) and 28.2% had symptoms associated with clinical levels of anxiety (SAS > 45). Among women within the postnatal period (N = 77), 63.6% had symptoms of possible depression, whereas 48,1% had symptoms of probable anxiety. Logistic regression showed that symptoms of postnatal depression were higher for respondents who had four or more living children relative to those having their first child (Odds Ratio: 0.07, C.I. = 0.01-0.42), and for those with a poor relationship with their partner (Odds Ratio: .09, C.I. =0.03-0.25). Any lifetime exposure to stressful events was the only predictor of symptoms of postnatal anxiety (Odds Ratio = 0.20, C.I. = 0.09-0.44).
CONCLUSIONS
Symptoms of postnatal depression and anxiety were prevalent in this Rwandan sample and most strongly predicted by interpersonal and social factors, suggesting that social interventions may be a successful strategy to protect against maternal mental health problems in the Rwandan context.
背景
围产期抑郁和焦虑在卢旺达等中低收入国家日益被视为重要的公共卫生问题，可能对母亲及其婴儿都有负面影响。由于贫困、低教育水平、负面生活事件和婚姻问题等风险因素普遍存在，卢旺达的产妇心理健康可能特别受到挑战。然而，关于卢旺达围产期抑郁和焦虑症状的数据有限。因此，本研究旨在探讨卢旺达围产期抑郁和焦虑症状的流行情况，以及与之相关的因素。
方法
2013 年 10 月，在 1 个月的时间内，对 165 名处于围产期（妊娠第二和第三阶段，产后 1 年内）的妇女进行了个体访谈。这些妇女在东部省的 5 家卫生中心或附属区医院接受了访谈。参与者回答了社会人口学问题和测量围产期抑郁（EPDS：爱丁堡产后抑郁量表）和焦虑（SAS：Zung 自评焦虑量表）症状的量表。
结果
在产前妇女中（N=85），37.6%的人有抑郁症状（EPDS≥10），28.2%的人有临床焦虑症状（SAS>45）。在产后妇女中（N=77），63.6%的人有抑郁症状，而 48.1%的人有焦虑症状。Logistic 回归显示，与有第一个孩子的受访者相比，有 4 个或更多孩子的受访者产后抑郁症状更高（优势比：0.07，置信区间：0.01-0.42），与伴侣关系不好的受访者产后抑郁症状更高（优势比：0.09，置信区间：0.03-0.25）。任何终生接触压力事件是产后焦虑症状的唯一预测因素（优势比=0.20，置信区间：0.09-0.44）。
结论
在卢旺达的这一样本中，产后抑郁和焦虑症状普遍存在，人际和社会因素是最强的预测因素，这表明社会干预可能是保护卢旺达产妇心理健康的一种成功策略。
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