산후우울증 관련요인: 전향적 코호트 연구 = Predictors of Postpartum Depression: Prospective Cohort Study

다국어 초록 (Multilingual Abstract)

Purpose: This prospective cohort study was done to investigate recall bias to antepartum variables measured at postpartum periods and predictors of postpartum depression. Methods: Participants were 215 women who answered a self-administered questionnaire which included demographics, Postpartum Depression Predictors Inventory-Revised and Korean version of Edinburgh Postpartum Depression Scale at antepartum 36-40 weeks and postpartum 2 weeks and 6 weeks. Data were analyzed using kappa, and hierarchical multiple logistic regression. Results: Agreement between antepartum variables at both antepartum and two postpartum periods was relatively high (κ=.55- .95). Postpartum depression rates were 36.3% and 36.7% at two follow-up points. In hierarchical multiple logistic regression analysis, prenatal depression (OR=4.32, 95% CI: 1.41-13.19;OR=5.19, 95% CI: 1.41-19.08), social support (OR=1.40, 95% CI: 1.18-1.66; OR=1.27, 95% CI: 1.06-1.53) and maternity blues (OR=4.75, 95% CI: 1.89-11.98; OR=4.22, 95% CI: 1.60-11.12) were commonly associated with postpartum depression at two follow-up points. Child care stress (OR=1.85, 95% CI: 1.01-3.37) was only associated with postpartum depression at 2 weeks postpartum and pregnancy intendedness (OR=1.57, 95% CI: 1.09-2.27) was only associated with postpartum depression at 6 weeks postpartum. Conclusions: The results indicate a need to apply nursing interventions such as prenatal education and counseling with families from antenatal period.

참고문헌 (Reference)

1 김용구, "한국판 Edinburgh Postnatal Depression Scale의 임상적 적용" 대한신경정신의학회 47 (47): 36-44, 2008

2 한귀원, "한국어판 에딘버러 산후우울 척도 : 신뢰도와 타당도" 대한생물치료정신의학회 10 (10): 201-206, 2004

3 여정희, "출산 후 6개월 여성의 산후우울 정도와 예측요인" 여성건강간호학회 12 (12): 355-362, 2006

4 권미경, "영아기 어머니의 산후 우울 정도와 모성역할 자신감, 양육 스트레스, 영아기질에 관한 연구" 아동간호학회 12 (12): 314-321, 2006

5 김재원, "산후의 우울 증상과 연관된 심리사회적 및 산과적 변인" 대한신경정신의학회 44 (44): 213-220, 2005

6 김미운, "산후우울증의 선별도구 간 일치도 및 관련 요인 연구" 대한산부인과학회 52 (52): 1133-1143, 2009

7 김증임, "산욕기 산모의 임신시 정서상태, 분만준비도, 산후 사회적 지지도 및 산후 우울감과의 관계연구" 여성건강간호학회 11 (11): 38-45, 2005

8 안옥심, "산욕기 산모의 산후 우울과 양육스트레스 및자아존중감과의 관계" 한국모자보건학회 10 (10): 58-68, 2006

9 Viera, A. J., "Understanding interobserver agreement : The kappa statistic" 37 (37): 360-363, 2005

10 Moses-Kolko, E. L, "Transdermal estradiol for postpartum depression: A promising treatment option" 52 (52): 516-529, 2009

11 Chaudron, L. H., "The relationship between postpartum psychosis and bipolar disorder : A review" 64 (64): 1284-1292, 2003

12 Corwin, E. J, "The heritability of postpartum depression" 12 (12): 73-83, 2010

13 Oppo, A, "Risk factors for postpartum depression: The role of the postpartum depression predictors inventory-revised (PDPI-R). Results from the perinatal depression-research & screening unit (PNDReScU) study" 12 (12): 239-249, 2009

14 Beck, C. T., "Revision of the postpartum depression predictors inventory" 31 (31): 394-402, 2002

15 Jang, E. J., "Psychosocial and obstetric factors associated with postpartum depressive symptoms" Dongguk University 2008

16 Centers for Disease Control and Prevention, "Prevalence of self-reported postpartum depressive symptoms-17 states, 2004-2005" 57 (57): 361-366, 2008

17 Josefsson, A., "Prevalence of depressive symptoms in late pregnancy and postpartum" 80 (80): 251-255, 2001

18 Paulson, J. F., "Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis" 303 (303): 1961-1969, 2010

19 Beck, C. T., "Predictors of postpartum depression : An update" 50 (50): 275-285, 2001

20 Ji-Hyang Youn, "Predictive Validity of the Postpartum Depression Predictors Inventory-Revised" 한국간호과학회 5 (5): 210-215, 2011

21 Kim, S. O., "Postpartum depression and maternal identity of the high risk women" Kwandong University 2009

22 Ryu, J. M., "Postpartum depression and its predictors at 1 to 6 months postpartum in Korea" Hanyang University 2008

23 Meadows, S. O., "Parental depression and anxiety and early childhood behavior problems across family types" 69 (69): 1162-1177, 2007

24 Avan, B, "Maternal postnatal depression and children's growth and behaviour during the early years of life: Exploring the interaction be tween physical and mental health" 95 (95): 690-695, 2010

25 Beck, C. T., "Further development of the postpartum depression predictors inventory-revised" 35 (35): 735-745, 2006

26 Miyake, Y., "Employment, income, and education and risk of postpartum depression: The Osaka maternal and child health study" 130 (130): 133-137, 2011

27 American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" Author 2000

28 Cox, J. L., "Detection of postnatal depression. Development of the 10-item edinburgh postnatal depression scale" 150 : 782-786, 1987

29 Rubertsson, C, "Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample" 8 (8): 97-104, 2005

30 Bae, J. I., "Construction of a postpartum depression model" 11 (11): 572-587, 2002

31 Gjerdingen, D. K., "Changes in women’s physical health during the first postpartum year" 2 (2): 277-283, 1993

32 Gupta, R, "Attention and memory biases as stable abnormalities among currently depressed and currently remitted individuals with unipolar depression" 3 : 99-, 2012