산후의 우울 증상과 연관된 심리사회적 및 산과적 변인

Psychosocial and Obstetric Factors Associated with Postpartum Depressive Symptoms

Objectives：The purpose of this study is to examine the psychosocial and obstetric factors associated with postpartum depressive symptoms in Korea. Methods：At the 1-week and 4-week postpartum visit, 61 postpartum women completed Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), Stait-Trait Anxiety Inventory (STAI), and Symptom Check List-90-Revised (SCL-90-R). Data related to psychiatric and obstetric characteristics, pregnancy and delivery related events were collected from standard medical records. 42 women without a history of pregnancy or delivery within 6 months were recruited as a control group. The postpartum group were divided into depressive and non-depressive groups according to the EPDS and BDI results of 4-week postpartum. Results：Compared to the normal control group, the mean scores of EPDS and BDI at 1-week postpartum were significantly higher (p<.05 and p<.01, respectively) in the postpartum group. The postpartum group also scored significantly higher in the somatization, psychoticism, and global severity index profiles according to the SCL-90-R results (p<.05). The mean score of BDI at 4-week postpartum was significantly higher (p<.01) in the postpartum group. There were significant correlations (p<.01) between the EPDS and BDI reports at 1- and 4-week postpartum. The rates of having experienced severe emotional stress during pregnancy and of smokers and drinkers before pregnancy were significantly higher (p<.05) in the postpartum depressive group (EPDS ≥10 and BDI ≥10) compared to the postpartum non-depressive group. The rate of having experienced depressive symptoms at 1-week postpartum was also significantly higher in the postpartum group. The depressive symptomatology at 1-week postpartum was identified as a significant risk factor for the depressive symptoms of 4-week postpartum when multiple logistic regression analysis was performed after controlling for age and education level. Conclusion：These findings suggest that postpartum women in Korea have many psychiatric problems such as depressive mood and somatization which necessitate proper care and assessment during the early postpartum period. Stress management during pregnancy may be helpful as a measure of preventing postpartum depression.