產後憂鬱與母嬰連結之變化、相關因子、預測因子探討

Predictors of and Changes in Postpartum Depression and Mother-Infant Bonding

研究目的：本研究旨在探討婦女產後初期至產後六個月之間，產後低落／憂鬱與母嬰連結的變化，以及預測產後六個月憂鬱與母嬰連結之因子，並探討憂鬱與母嬰連結之相互預測力。研究方法：以縱貫研究方式邀請於2011年12月至2012年6月生產之婦女於產後初期填寫個人資料表，並於產後初期與產後六個月填寫母嬰連結量表、愛丁堡產後憂鬱量表與社會支持量表。共獲有效問卷291份，以SPSS 17.0版進行分析。研究結果：由產後初期至產後六個月，婦女的憂鬱程度有下降的現象，母嬰連結則大致有增高的現象。產後六個月憂鬱之預測變項為產後低落、孕期憂鬱；產後六個月各母嬰連結之預測變項是產後初期各母嬰連結因素、娘家支持。先生支持、婆家支持、孕期焦慮在部份母嬰連結因素上具有預測力。研究結論：孕期情緒、產後低落對產後六個月之憂鬱或母嬰連結具有預測力，因此產婦的心理健康工作，由孕期、產後初期即應著手。產後憂鬱、母嬰連結無法相互預測，且各有其預測因子，因此實務工作者對二者皆須加以評估，並須以不同的工作策略預防產後六個月之憂鬱與母嬰連結問題。

Purpose: In this study the author investigated predictors of and changes in women’s postpartum blues/depression and mother-infant bonding from 3 days to 6 months after delivery. Methods: A valid sample of 291 Taiwanese women who gave birth between Dec. 2011 and June 2012 provided personal information at 3 days postpartum and completed questionnaires regarding 4 mother-infant bonding aspects, depression, and various sources of social support at 3 days and 6 months postpartum. Results: The t-test, analysis of variance, correlation analysis and regression analysis showed that most women followed a trend of decreasing depression as they increased on most bonding factors over the 6 months. Predictors of 6-month postpartum depression were depression in the early postpartum days and during the pregnancy. The predictors of 6-month mother-infant bonding were specific bonding factors in the early postpartum days and social support from their parents. Social support from the partner and the partners’ family, perinatal anxiety predicted some bonding factors. Conclusions: Mental health support for perinatal women should be initiated prenatally, or at least in the early postpartum period. Postpartum depression and mother-infant bonding may be distinct phenomena that are predicted by different variables. Practitioners should monitor postpartum depression, mother-infant bonding, and their predictors in order to prevent postpartum depression and negative mother-infant bonding.