کیفیت خواب در اواخر بارداری و افسردگی پس از زایمان

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پزشکی، دانشگاه تربیت مدرس تهران، تهران، ایران.

2 استادیار بهداشت، دانشکده پزشکی، دانشگاه تربیت مدرس تهران، تهران، ایران.

3 دانشیار گروه آمار زیستی، دانشکده پزشکی، دانشگاه تربیت مدرس تهران، تهران، ایران.

چکیده

مقدمه: بارداری از نظر فیزیولوژیکی و روانشناختی بر خواب زنان اثر می گذارد. به نظر می رسد کیفیت نامطلوب خواب در اواخر بارداری پیشگویی کننده علایم افسردگی در چند هفته اول پس از زایمان می باشد. از این رو پژوهش حاضر با هدف بررسی ارتباط کیفیت خواب در اواخر بارداری با علائم افسردگی پس از زایمان صورت گرفت.
روش‌کار: این مطالعه طولی آینده نگر بر روی 156 زن حامله نخست زا با سن حاملگی 30 - 28 هفته بارداری از 10 مرکز بهداشتی درمانی قم انجام شد. افراد مورد مطالعه پرسشنامه ای شامل شاخص کیفیت خواب پیتزبورگ، سنجش اضطراب اسپیل برگر و نگرش زایمان هارتمن را در هفته 28 و مجدداً در هفته 38 بارداری تکمیل کردند. 3 ماه پس از زایمان، علائم افسردگی آنان با استفاده از پرسشنامه ادینبورگ بررسی شد. داده ها از طریق آزمون کای دو و منتل هنزل، تحلیل رگرسیون لوجستیک و آنالیز واریانس دو طرفه با استفاده از نرم افزار SPSS(نسخه 16) تجزیه و تحلیل شد.
 
یافته‌ها: ارتباط آماری معنی داری بین نمرات کیفیت خواب هفته 28 و 38 بارداری با علائم افسردگی پس از زایمان یافت شد (05/0<p). کیفیت نامطلوب خواب در هفته 28 بارداری (9/3=OR) و هفته 38 بارداری (4/3=OR) تقریباً چهار برابر شانس خطر علائم افسردگی پس از زایمان را افزایش می دهد (03/0=p).
 
نتیجه‌گیری: کیفیت خواب عامل مستعد کننده افسردگی پس از زایمان می باشد. از این رو ارزیابی کیفیت خواب در زنان باردار و ارائه مداخلات مناسب در طول بارداری برای کاهش افسردگی پس از زایمان پیشنهاد می شود.

کلیدواژه‌ها


عنوان مقاله [English]

Sleep Quality in Late Pregnancy and Postpartum Depression

نویسندگان [English]

  • Zahra Alipour 1
  • Meynoor Lamyian 2
  • Ebrahim Hajizadeh 3
1 M.Sc. of Midwifery, Faculty of Medicine, Tarbiat Modares of Tehran, Tehran, Iran.
2 Assistant Professor of Health, Faculty of Medicine, Tarbiat Modares University of Tehran, Tehran, Iran.
3 Associate Professor of Vital Statistics, Faculty of Medicine, Tarbiat Modares University of Tehran, Tehran, Iran.
چکیده [English]

Introduction: Pregnancy affects on women’s sleep physiologically and psychologically. Poor sleep quality in late pregnancy seems to be a predictive of depressive symptoms at first few weeks of post birth. The purpose of this study was to investigate the relationship between quality of sleep in late pregnancy and postpartum depressive symptoms.
Methods: This prospective longitudinal study was performed on 156 women with gestational age of 28-30 weeks from 10 prenatal care clinics of Qom, Iran. Subjects completed a questionnaire including the Pittsburgh Sleep Quality Index (PSQI), State-Trait Anxiety Inventory (STAI) and Childbirth Attitudes Questionnaire (CAQ) at 28 and again at 38 weeks of gestation. Three months after delivery, depressive symptoms were assessed using the Edinburgh Postpartum Depression Scale (EPDS). Data was analyzed by Chi-square test, Mantel Haenszel and logistic regression and Two-Way ANOVA Analysis of Variance using SPSS softwareversion16.
Results: Significant relationship was found between quality sleep scores at 28 and 38 weeks of gestation and postpartum depressive symptoms (p>0.05). Inappropriate sleep quality at 28 weeks (OR=3.9) and 38 weeks (OR=3.4) increases the risk of postpartum depressive symptoms nearly four times (p=0.03).
Conclusion: Quality of sleep is a predisposing factor of postpartum depression. Therefore, assessing the sleep quality of pregnant women and providing proper interventions during pregnancy is suggested to reduce the rate of postpartum depression.

کلیدواژه‌ها [English]

  • Nulliparous women
  • Postpartum Depression
  • pregnancy
  • Sleep Quality
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