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1、POSTPARTUMDEPRESSIONBEYONDTHEBLUESDebbyCarapezza,R.N.,M..S.N.NurseConsultant,ReproductiveHealthProgramUtahDepartmentofHealthINCIDENCEOFDEPRESSIONEachyear,15%to20%ofadultsintheUnitedStatesexperienceamajordepressionTheincidenceamongwomenistwicethatofmenandpea
2、ksbetween18to44yearsofage-thechildbearingyearsDEPRESSIONINWOMENWomenareatincreasedriskofmooddisordersduringperiodsofhormonalfluctuation-premenstrualpostpartumperimenopausalTHERANGEOFPOST-DELIVERYMOODDISORDERS50%to80%ofwomenexperiencetransient“babyblues”with
3、inthefirsttwoweeksfollowingdelivery0.1%to0.2%ofwomenexperiencepostpartumpsychosisusuallywithinthefirst4weeksfollowingdeliveryPOSTPARTUMDEPRESSION6.8%to16.5%ofwomenexperiencepostpartumdepression(PPD)alsoknownaspostpartummajordepression(PMD)Onsetcanbeasearlya
4、s24hoursoraslateasseveralmonthsfollowingdeliverySYMPTOMSOFPOSTPARTUMDEPRESSIONRANGEOFSYMPTOMSSymptomsrange-frommilddysphoriatosuicidalideationtopsychoticdepressionDURATIONOFSYMPTOMSUntreated,symptomscanlast:severalmonthsintothesecondyearpostpartumTHEETIOLOG
5、YOFPOSTPARTUMDEPRESSIONVarioustheoriesbasedinphysiologicalchangeshavebeenpostulated:hormonalexcessesordeficienciesofestrogen,progesterone,prolactin,thyroxine,tryptophan,amongothersETIOLOGYOFPOSTPARTUMDEPRESSIONOthertheoriescitenumerouspsychosocialfactorsass
6、ociatedwithPMD:maritalconflictchild-caredifficulties(feeding,sleeping,healthproblems)perceptionbymotherofaninfantwithadifficulttemperamenthistoryoffamilyorpersonaldepressionPOSTPARTUMDEPRESSIONINUTAHWhatcanPRAMS*datatellus?*PRAMSisanongoing,population-based
7、riskfactorsurveillancesystemdesignedtoidentify&monitorselectedmaternalexperiencesthatoccurbefore&duringpregnancy&experiencesofthechild’searlyinfancy.INDICDENCEOFPOSTPARTUMDEPRESSIONAMONG2000UTAHPRAMSRESPONDENTS24.1%ofPRAMSrespondentsindicatedthatinthemonths
8、afterdeliverytheyweremoderatelytoverydepressedWhentheresultsofthesurveyareweightedtorepresentall47,331Utahwomenwhohadalivebirthin2000,thismeansanestimated11,416womenreportedbeingmoderatelyorverydepress