Analysis of independent risk factors for postpartum depression in elderly primiparas and the effects of mindfulness-based psychological intervention

老年初产妇产后抑郁症独立危险因素分析及正念心理干预效果

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作者:Baihong Wu, Nan Wang, Lili Hu, Guohe Wu

Conclusion

Mindfulness-based psychological intervention demonstrates positive effects on enhancing self-efficacy, emotional well-being, and sleep quality among elderly primiparas experiencing postpartum depression. Additionally, advanced maternal age, higher education level, presence of pregnancy complications, and relatively lower newborn Apgar score are independent risk factors for postpartum depression in elderly primiparas.

Methods

A retrospective analysis was conducted on 75 women with postpartum depression who received treatment at the First Hospital of Nanchang from January 2021 to March 2022. Among them, 33 women who received routine psychological health management were included in the control group, while the remaining 42 who received mindfulness-based psychological intervention on the basis of routine psychological health management were included in the study group. In addition, 80 women without postpartum depression who delivered during the same period at our hospital were selected as the non-depression group. The self-cognitive function scores, depression and anxiety scores, sleep quality and progesterone level were compared between the two groups before and after the intervention. Logistic regression analysis was used to identify the influencing factors for postpartum depression in elderly primiparas.

Objective

To identify the independent risk factors for postpartum depression in elderly primiparas and to evaluate the effects of mindfulness-based psychological intervention.

Results

Before the intervention, no significant difference was found in General Self-Efficacy Scale (GSES) scores between the two groups (P > 0.05). After the intervention, the GSES scores significantly improved in both groups, with the study group showing a significantly higher improvement compared to the control group (P < 0.05). Before the intervention, no significant difference was observed between the two groups in Edinburgh Postnatal Depression Scale (EPDS) and 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) scores (all P > 0.05). After the intervention, the EPDS and GAD-7 scores significantly decreased in both groups, with the study group showing a significantly greater reduction compared to the control group (all P < 0.05). Before the intervention, no significant difference was found in Pittsburgh Sleep Quality Index (PSQI) scores between the two groups (P > 0.05). After the intervention, the PSQI scores notably decreased in both groups, with the study group showing notably lower scores compared to the control group (P < 0.05). Before the intervention, there was no significant difference in progesterone levels between the two groups (P > 0.05). After the intervention, progesterone levels significantly decreased in both groups, and the intervention group showed significantly lower levels compared to the control group (P < 0.05). Logistic regression analysis identified age (P < 0.0001; OR: 5.471; 95% CI: 2.504-11.956), education level (P = 0.029; OR: 2.370; 95% CI: 1.094-5.137), pregnancy complications (P = 0.006; OR: 3.665; 95% CI: 1.460-9.199), and newborn Apgar score (P = 0.046; OR: 2.895; 95% CI: 1.017-8.242) as independent risk factors for postpartum depression in elderly primiparas.

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