目的 评估硬膜外分娩镇痛(LEA)对产妇产后抑郁(PPD)的影响.方法 选择经阴道分娩的初产妇628例,年龄20～36岁,BMI 20～35 kg/m2,ASAⅡ或Ⅲ级.根据产妇是否接受硬膜外分娩镇痛分为两组:镇痛组(n=322)和非镇痛组(n=306).记录分娩期间VAS疼痛评分最高值、产程时间、出血量、新生儿1、5 min Apgar评分和新生儿入NICU的发生情况.于分娩前1周和产后2周、6周分别采用爱丁堡产后抑郁量表(EPDS)评估PPD发生情况(EPDS评分≥11分为PPD),采用广泛性焦虑量表(GAD-7)评估产妇焦虑情绪,采用领悟社会支持量表(PSSS)评估产妇感受到的总社会支持度.结果 与非镇痛组比较,镇痛组产妇分娩期间VAS疼痛评分最高值明显降低(P＜0.05).两组产妇第一产程时间、第二产程时间、出血量、新生儿1、5 min Apgar评分、新生儿入NICU比例差异无统计学意义.两组产妇产后2、6周PPD发生率、PSSS高支持状态、GAD-7≥10分差异无统计学意义.结论 初产妇接受LEA不影响产后抑郁的发生风险.
Effects of labor epidural analgesia on postpartum depression
Objective To investigate the effect of labor epidural analgesia(LEA)on postpartum depression(PPD).Methods A total of 628 primiparous,aged 20-36 years,BMI 20-35 kg/m2,ASA physical status Ⅱ or Ⅲ,and delivering vaginally were enrolled.According to maternal choice of receiving epidural labor analgesia or not,primiparous were divided into two groups:analgesic group(n=322)and non-analgesic group(n=306).VAS pain scores,duration of labor,postpartum hemorrhage,Apgar scores of newborns,and proportion of neonates admitted to the NICU were recorded.The Edinburgh postpartum de-pression scale(EPDS)was used to assess the occurrence of PPD(EPDS score ≥ 11 considered positive for postpartum depression),the generalized anxiety disorder 7-item scale(GAD-7)was used to assess ma-ternal anxiety,and the perceived social support scale(PSSS)was used to assess total social support at 1 week before delivery,2 and 6 weeks after delivery,respectively.Results Compared with the non-analgesic group,the VAS pain score during labor was significantly lower in the analgesic group(P＜0.05).The first stage of labor duration,the second stage of labor duration,postpartum hemorrhage,1 minute and 5 minutes Apgar scores for newborns,and the proportion of neonatal admitted to NICU were not statistically significant.The incidence of PPD,PSSS high support state,and GAD-7≥10 at 2 and 6 weeks after delivery had no statistically significant between the two groups.Conclusion There was no significant difference in the risk of postpartum depression between primiparous receiving epidural labor analgesia or not.
万方数据
维普
