Objective: To investigate the situation of social support (SS), and explore its relationship with antenatal depression (AD) among Zhejiang primiparas in their third trimesters. Methods: From March to August 2016, a cross-sectional study was conducted and the questionnaire was used at the outpatient consulting room of one maternity hospital in Hangzhou. Inclusion criteria includes the primiparas over 18 years old, gestation from 30 to 36 weeks, been able to understand and complete the questionnaires independently, no family history and history of mental disorders and no use of psychotropic drugs, without serious illness and so on. Exclusion criteria was that the primiparas were unable to complete all the contents of the questionnaire and of poor compliance. 1 150 questionnaires were actually given out, and 1 075 questionnaires were valid, so the valid rate was 93.48%. AD was evaluated by the Edinburgh Postnatal Depression Scale (EPDS) and SS was evaluated by the Perceived Social Support Scale (PSSS). SS between the non-AD group and the AD group was compared. The correlation between SS and AD was analyzed. Binary logistic regression model was used to assess the relationship between SS and AD. The level of SS was divided by average scores, groups lower than the average score was defined as the low-score group, groups higher than the average score was defined as the high-score group. Results: The prevalence of AD (score≥9) was 27.3% (293/1 075) among Zhejiang primiparas in their third trimesters. The scores of family support, friend support and other support, and the total score of SS among the non-AD group were 24.80±2.83, 23.40±3.00, 21.91±3.54 and 70.11±7.92, respectively, which were higher than those in the AD group (22.71±3.88, 21.45±3.59, 19.95±3.97, 64.10±10.01), (t values were 8.43, 8.29, 7.83 and 9.25, respectively, P<0.001 for all). The scores of family support, friend support and other support, and the total score of SS were negatively correlated with AD (rs values were-0.26,-0.25,-0.22 and-0.28, respectively, P<0.001 for all). Compared with low-score group, the scores of family support, friend support and other support, and the total score of SS among the high-score group had a lower risk of antenata depression among primiparas in their third trimesters, OR(95%CI) values were 0.56 (0.41-0.77), 0.66(0.47-0.92), 0.57(0.41-0.79) and 0.36(0.27-0.48), respectively. Conclusion: The prevalence of AD among Zhejiang primiparas was relatively high, and AD was negatively associated with SS level. We suggest adding SS in community pregnancy health management service in the future.
目的： 调查浙江省初产妇孕晚期社会支持状况，并探讨其与产前抑郁的关系。 方法： 采用横断面研究，于2016年3—8月在杭州某妇产科医院门诊预诊室进行现场问卷调查。纳入标准：年龄≥18周岁；孕周为30~36周；初产妇；能理解并能独立完成问卷填写；无精神障碍家族史和既往史，并且未使用影响精神活动的药物；无其他严重疾病。排除标准：不能坚持完成问卷全部内容，依从性不好者。实际发放1 150份调查问卷，有效回收1 075份，有效回收率93.48%。采用爱丁堡产后抑郁量表筛查产前抑郁；采用领悟社会支持量表评估社会支持状况。比较非产前抑郁组与产前抑郁组社会支持情况的差异；分析社会支持与产前抑郁的相关性；采用二分类logistic回归模型，以社会支持平均分为界值，<平均分为低分组，≥平均分为高分组，分析社会支持和产前抑郁的关系。 结果： 浙江省初产妇孕晚期产前抑郁（得分≥9分）检出率为27.3%（293/1 075）。非产前抑郁组的家庭支持、朋友支持、其他支持得分以及社会支持总分分别为（24.80±2.83）、（23.40±3.00）、（21.91±3.54）和（70.11±7.92）分，均高于产前抑郁组[分别为（22.71±3.88）、（21.45±3.59）、（19.95±3.97）、（64.10±10.01）分]（t值分别为8.43、8.29、7.83、9.25，P值均<0.001）；家庭支持、朋友支持、其他支持得分及社会支持总分与产前抑郁呈负相关（rs值分别为-0.26、-0.25、-0.22、-0.28，P值均<0.001）；与低分组相比，家庭支持、朋友支持、其他支持得分及社会支持总分的高分组初产妇孕晚期抑郁风险较低，OR（95%CI）值分别为0.56（0.41~0.77）、0.66（0.47~0.92）、0.57（0.41~0.79）、0.36（0.27~0.48）。 结论： 浙江省初产妇产前抑郁检出率较高，且与社会支持水平相关，建议今后可在社区孕期健康管理服务中增加社会支持。.
Keywords: Depression; Pregnant women; Social support; The third trimester.