Title: Prevention and care of postpartum hemorrhage ABSTRACT Objective To investigate the incidence rate of postpartum depression and its relatedpregnancy nutrition and psychosocial factors. Methods The study was carried out in four hospitals selected by stratified sampling inshihezi city. 314 nullipara women who met the designed including criteria at 6 weeks postpartum were recruited by cluster sampling from the three hospitals between March 2010 and October 2010. Participants were assessed by using Edinburgh Postpartum Depression Scale (EPDS), self-designed demographic and obstetrical and psychosocial factors questionnaires. The EPDS is a 10-item self-report scale, specially designed to screen for postpartum depression (PPD). Each item is scored on a 4-point scale from "No, not at all"(0) to "Yes, most of the time"(3), the minimum and maximum total score ranging from 0 to 30,respectively. The cutoff scores of 13 on the EPDS are used to screen for clinical depression. Participants are asked to underline the response that is the most true for them within the past 7 days. The sensitivity for the detection of major depression was 81.82%, the specificity 95.83%. The split-half reliability was 0.59. All statistical analyses were done using the SPSS program, Version 11.5. Descriptive analyses, Chi-square test, simple and multiple factor non-conditional logistic regression analyses were performed. Results l.ln this study completed records were obtained on 304 women, yielding a completion rate of 96.8%.2.The incidence rate of depressive symptoms, an EPDS score of 13 or more, was 16.8% at the 6 weeks postpartum. 3.Anxiety and depression during pregnancy are more prone to Post Natal Depression. Conclusions The 6 weeks after childbirth appears to be a time of heightened vulnerability for the development of depression in some women. Depression in the postpartum period needs our special attention as it can have severe consequences not only for the mother, but also for the infant and the whole family. The study shows that there are four obstetrical risk factors, including medication during pregnancy, Maternal Education Level, history of stillbirth, and fetal distress, including prenatal anxiety breast-feeding. And the study also suggests that there are four psychosocial risk factors, including cadre and clerisy, poor living conditions, female and inadequate family supports, and two protective factors, Expectations Children. In addition preventive intervention should be taken actively to help prevent against postpartum depression.
Key words: postpartum depression, EPDS ,pregnancy psychosocial status
