Postpartum depression refers to women who have obvious depressive symptoms or typical depressive episodes during the puerperium. It belongs to the puerperal psychiatric syndrome, which is the same as postpartum restlessness and postpartum psychosis.
The incidence rate is 15% to 30%. The typical postpartum depression occurs within 6 weeks after delivery and can recover on its own within 3 to 6 months, but it can also last for 1 to 2 years in severe cases, and there is a recurrence rate of 20% to 30% in the second pregnancy. Its clinical features are not significantly different from other time depressive episodes.
1. Biological factors
(1) Endocrine factors During the process of pregnancy and childbirth, the endocrine environment in the body has undergone great changes, especially in the 24 hours postpartum, the rapid changes in hormone levels in the body are the biological basis for the occurrence of postpartum depression. Studies have found that the release of placental steroids before labor reaches the highest value, and the patient is happy; the patient is depressed when the secretion of placental steroids suddenly decreases after childbirth.
(2) Genetic factors There is a high incidence of postpartum depression in women who have a family history of psychosis, especially those with a family history of depression.
(3) Obstetric factors The prenatal mentality is related to the onset of postpartum depression. During childbirth, postpartum complications, dystocia, delayed labor, use of assisted reproductive technology, the long first stage of labor, vaginal delivery, surgery, etc. will all affect the lying-in woman Bring tension and fear, leading to increased physical and psychological stress, and induce postpartum depression.
(4) Physical disease factors Parturients with physical disease or disability have developed postpartum depression, especially infection and fever have a certain influence on the onset of postpartum depression. In addition, the susceptibility of central nervous function, the influence of emotional and motor information processing and regulation systems (such as dopamine) may be related to the occurrence of postpartum depression.
2. Psychosocial factors
Maternal personality characteristics, insufficient mental preparation before delivery, poor adjustment after delivery, the poor mood in the early postpartum period, insufficient sleep, excessive fatigue in caring for the baby, young maternal age, discordance between husband and wife, lack of social support, family economic status, the attitude of medical staff during delivery, Infant gender and health status, etc., are closely related to the occurrence of postpartum depression.
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