ارﺗﺒﺎط ﺑﯿﻦ ﺷﯿﺮدﻫﯽ و اﻓﺴﺮدﮔﯽ ﭘﺲ از زاﯾﻤﺎن در زﻧﺎن ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﻣﺮاﮐﺰ ﺑﻬﺪاﺷﺘﯽ ﺷﻬﺮﺳﺘﺎن درهﺷﻬﺮ، اﺳﺘﺎن اﯾﻠﺎم

The relationship between breastfeeding and Postpartum Depression in women referring to Health Centers in Darreh Shahr County, Ilam Province

زﻣﯿﻨﻪ و ﻫﺪف اﻓﺴـﺮدﮔﯽ ﭘﺲ از زاﯾﻤﺎن)PPD( اﭘﯿﺰودي از اﻓﺴﺮدﮔﯽ ﻣﺎژور اﺳﺖ ﮐﻪ ﺗﺄﺛﯿﺮات ﻣﻨﻔﯽ ﺑﺴﯿﺎري ﺑﺮ ﻣﺎدر و ﻓﺮزﻧـﺪش دارد. ﻋﻮاﻣﻠﯽ در ﻧﻘﺶ ﻓـﺎﮐﺘﻮرﻫﺎي ﭘﯿﺸـــﮕﻮﯾﯽﮐﻨﻨﺪه در ﺣﻮل زاﯾﻤﺎن، ﻣﺎﻧﻨﺪ اﻓﺴـــﺮدﮔﯽ در ﻗﺒﻞ و ﻃﯽ ﺑﺎرداري و ﺗﻮﻟﺪ ﭘﯿﺶ از ﻣﻮﻋﺪ ﻧﻮزاد، ﺑﺮاي آن ﺷﻨﺎﺧﺘﻪ ﺷﺪه اﺳﺖ. ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺑﺮرﺳﯽ ارﺗﺒﺎط ﺷﯿﺮدﻫﯽ ﺑﺎ PPDاﻧﺠﺎم ﺷﺪه اﺳﺖ. ﻣﻮاد و روشﻫﺎ اﯾﻦ ﭘﮋوﻫﺶ از ﻧﻮع ﻃﻮﻟﯽ و از ﺑﯿﻦ 365 ﺧﺎﻧﻢ ﺑﺎردار 38 ﻫﻔﺘﻪاي ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ درﻣﺎﻧﮕﺎهﻫﺎي ﺷﻬﺮﺳﺘﺎن درهﺷﻬﺮ، اﺳﺘﺎن اﯾﻠﺎم، در ﺳﺎل 94-95 اﻧﺠﺎم ﺷﺪه اﺳﺖ. ﺗﻌﺪاد 303 ﻧﻔﺮ ﮐﻪ در ﺑﺮرﺳﯽ ﺑﺎ ﭘﺮﺳﺶﻧﺎﻣﻪ ادﯾﻨﺒﺮگ دﭼﺎر اﻓﺴﺮدﮔﯽ ﻧﺒﻮدﻧﺪ وارد ﺑﺮرﺳﯽ ﺷﺪﻧﺪ. اﯾﻦ ﮔﺮوه در 6 ﺗﺎ 8 ﻫﻔﺘﻪ ﭘﺲ از زاﯾﻤﺎن ﻣﻮرد ﺑﺮرﺳﯽ ﻣﺠﺪد ﺑﺎ ﭘﺮﺳﺶﻧﺎﻣﮥ ادﯾﻨﺒﺮگ ﻗﺮار ﮔﺮﻓﺘﻨﺪ ﮐﻪ 31 ﻧﻔﺮ ﻧﻤﺮة 13 ﯾﺎ ﺑﯿﺸﺘﺮ ﮐﺴﺐ ﮐﺮدﻧﺪ. ﭘﮋوﻫﺶ ﺑﺮ 29 ﻧﻔﺮ اﻧﺠﺎم ﺷﺪ ﮐﻪ اﻓﺴﺮدﮔﯽ آﻧﺎن ﺗﻮﺳﻂ روانﭘﺰﺷﮏ ﺗﺄﯾﯿﺪ ﺷﺪ. ارﺗﺒﺎط ﺑﯿﻦ PPD ﺑﺎ ﺷﯿﺮدﻫﯽ و دﯾﮕﺮ ﻣﺘﻐﯿﺮﻫﺎي ﺗﺄﺛﯿﺮﮔﺬار ﺷﺎﻣﻞ ﻧﻮع زاﯾﻤﺎن، ﻣﺤﻞ زﻧﺪﮔﯽ و ﻏﯿﺮه ﺑﺎ ﺗﻘﺴﯿﻢ ﻧﻤﻮﻧﻪﻫﺎ ﺑﻪ 2 ﮔﺮوه اﻓﺴﺮده و ﻏﯿﺮ اﻓﺴﺮده ﺳﻨﺠﯿﺪه ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ از ﺑﯿﻦ ﻣﺘﻐﯿﺮﻫﺎي ﺑﺮرﺳﯽﺷﺪه ﺗﻨﻬﺎ ﺷﯿﺮدﻫﯽ ﺑﻮد ﮐﻪ ﺑﺎ اﻓﺴﺮدﮔﯽ ﭘﺲ از زاﯾﻤﺎن ﻣﺮﺗﺒﻂ ﺑﻮ )P=(0/004 و در آﻧﺎﻟﯿﺰ رﮔﺮﺳﯿﻮن ﭼﻨﺪ ﻣﺘﻐﯿﺮه ﻧﯿﺰ اﯾﻦ ارﺗﺒﺎط ﻫﻤﭽﻨﺎن ﺑﺮﻗﺮار ﺑﻮد)02/P=0(.. ﻧﺘﯿﺠﻪﮔﯿﺮي ﻧﺘﺎﯾﺞ ﺣﺎﺻﻞ ﻧﺸﺎن ﻣﯽدﻫﺪ در ﺻﻮرت ﺷﯿﺮدﻫﯽ اﻧﺤﺼﺎري ﺑﺎ ﺷﯿﺮ ﻣﺎدر از ﻣﯿﺰان اﺑﺘﻠﺎ ﺑﻪ PPD ﮐﺎﺳﺘﻪ ﻣﯽﺷﻮد. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ آﻣﺎر ﺑﺎﻟﺎي اﺑﺘﻠﺎ ﺑﻪ PPD در ﺑﺮﺧﯽ از ﻣﻨﺎﻃﻖ ﮐﺸﻮر ﺟﺎي آن دارد ﮐﻪ ﺑﺮاي ﮐﺎﺳﺘﻦ از اﯾﻦ ﻣﯿﺰان اﺑﺘﻠﺎ ﻣﺮاﻗﺒﺖﻫﺎي ﺑﻬﺪاﺷﺘﯽ وﯾﮋهاي در دوران ﭘﺲ از زاﯾﻤﺎن، ﻧﺴﺒﺖ ﺑﻪ ﺷﺮوع و ﺗﺪاوم ﺷﯿﺮدﻫﯽ اﻧﺤﺼﺎري ﺑﺎ ﺷﯿﺮ ﻣﺎدر ﺻﻮرت ﮔﯿﺮد.

Introduction: Postpartum depression (PPD) is an episode of major depression that has many negative effects on the mother and the newborn child. Some factors have been identified as the predictive factors for PPD in peripartum such as Peripartum and Postpartum Depression, and preterm labor. The aim of this study was to investigate the relationship between breastfeeding and PPD. Materials and Methods: This research was a longitudinal study conducted in Darreh Shahr County, Ilam Province in 2015-2016. Of the 365 women who were pregnant about 38 weeks, 303 ones who had no depression according to the Edinburgh questionnaire were put under the study. The under study group was reexamined again with the Edinburgh questionnaire 6 to 8 weeks after delivery. 31 of them achieved grade 13 or greater of whom 29 ones were approved that had depression by a psychiatrist. The study was conducted on this group. Afterwards the relationship between breastfeeding and PPD and other effective variables including type of delivery, place of residence and etc, was investigated by dividing the samples into two groups namely depressed and non-depressed subjects. Results: Among the variables studied it was only breastfeeding that was connected to postpartum depression (P=0/004). This relationship was also positive (P =0/ 02) in the multivariate regression analysis. Conclusion: The results revealed that in the case of exclusive breastfeeding, the rate of PPD was decreased. Due to the high rate of prevalence of PPD in some parts of the country, it is important to reduce the rate of this prevalence, the special health care is important during the postpartum period, relative to the initial, and the continuation of exclusive breastfeeding.