2023 年 3 月至 7 月期间肯雅塔国立医院和普姆瓦尼妇产医院中青少年母亲产后抑郁症的患病率、特征和相关决定因素:前瞻性横断面研究

Gathoni Muriithi, A.B Kihara, P. Kigamwa
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摘要

背景:产后抑郁症(PPD)是指妇女在分娩后 6 周内出现的抑郁发作。全球发病率为 13%-19%。产后抑郁症的长期后果包括母亲极有可能患上抑郁症、自杀和杀婴。目前,产后门诊还没有对产后抑郁症进行常规筛查:确定肯雅塔国立医院(KNH)和普姆瓦尼妇产医院(PMH)中青少年母亲产后抑郁症的发病率、特征和相关决定因素:这是一项横断面研究,涉及肯雅塔国立医院和普姆瓦尼妇产医院的162名征得同意的产后未成年母亲(14-19岁)。研究采用连续抽样法。数据收集采用结构化社会人口调查问卷和爱丁堡产后抑郁量表(EPDS)。数据使用 SPSS 25 版本进行分析。结果在所有参与者中,77.2%来自PMH,22.8%来自KNH。大多数参与者的年龄为 18-19 岁,最高学历为小学,单身,经济来源依靠父母,信奉基督教。在产科特征方面,大多数人没有流产史、初产妇、意外怀孕、以闭经为首发症状、在怀孕前三个月接受过首次产前检查、至少接受过四次产前检查、经阴道自然分娩。产后抑郁症的发病率为 22.2%。产后抑郁症最显著的特征是感到不知所措、悲伤、焦虑和哭泣。青春期母亲产后抑郁的相关决定因素包括:年龄小于 18 岁、在妊娠后三个月才开始接受产前检查、产前检查次数少于四次、HIV 阳性、伴侣不支持、母亲产后生病:这项研究表明,约四分之一的未成年母亲可能患有产后抑郁症。
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Prevalence, characteristics, and associated determinants of postpartum depression among adolescent mothers in Kenyatta National Hospital and Pumwani Maternity Hospital from March to July 2023: A prospective, cross-sectional study
Background: Postpartum depression (PPD) is a depressive episode that occurs in women within 6 weeks of parturition. It has a global prevalence of 13-19%. Long-term consequences include a high likelihood of experiencing depression in mothers, suicide, and infanticide. There is currently no routine screening for postpartum depression at the postnatal clinic. Objectives: To determine the prevalence of postpartum depression among adolescent mothers, characteristics, and associated determinants in Kenyatta National Hospital (KNH) and Pumwani Maternity Hospital (PMH). Methods: This was a cross-sectional study, involving 162 consenting postnatal adolescent mothers (14-19 years) at Kenyatta National and Pumwani Maternity hospitals. Consecutive sampling was employed. Data were collected using a structured sociodemographic questionnaire and the Edinburg Postpartum Depression Scale (EPDS). Data were analyzed using SPSS version 25.  Results: Of all participants, 77.2% were from PMH and 22.8% were from KNH. Most participants were 18–19 years old, had primary education as the highest entry level, were single, depended on their parents for financial support, and were Christians. For obstetric characteristics, the majority had no history of miscarriage, were primipara, had unintended pregnancy, had amenorrhea as the first symptom, had an initial antenatal clinic (ANC) visit during the first trimester, had at least four ANC visits, and delivered via spontaneous vaginal birth. The prevalence of postpartum depression was 22.2%. The most prominent characteristics of PPD were feeling overwhelmed, sadness, anxiety, and crying episodes. Associated determinants of PPD in adolescent mothers were age <18 years, starting ANC visits after the second trimester, less than four ANC visits, being HIV-positive, unsupportive partner, and having a post-delivery illness for the mother. Conclusion: This study established that approximately one in four adolescent mothers are likely to suffer from postpartum depression.  
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