目的 应用哺乳期膳食平衡指数法（DBI-L）评价产后哺乳期妇女膳食质量,分析膳食质量与产后抑郁（PPD）的相关性。方法 以2019年6–7月期间在北京城区6家社区卫生服务中心登记的401名产妇为研究对象,从孕产妇保健手册及社区母子健康档案收集一般情况及围产信息。在产后6月的随访中,收集当前婴儿喂养及产妇的照护状况,采用爱丁堡产后抑郁量表（EPDS）获取PPD相关信息,采用膳食频率法（FFQ）收集哺乳期妇女膳食情况,运用DBI-L评价膳食质量。结果 产妇PPD患病率为26.40%。产后哺乳期妇女中77.56%总体膳食不均衡,食物摄入过量（65.84%）和摄入不足（41.15%）的问题同时存在。与正常产妇相比,PPD产妇的膳食总体平衡性更差（P=0.001）,摄入过量（P<0.000）及摄入不足（P=0.04）的情况更为严重。其中,PPD产妇蔬菜水果摄入显著低于非PPD产妇（P<0.01）;谷薯类的摄入显著高于非PPD产妇（P<0.01）。产妇膳食摄入过量（中度摄入过量OR=5.855,95%CI：2.647~12.950;高度摄入过量OR=5.928,95%CI: 2.510~14.00）及膳食失衡（OR=7.924,95%CI：2.777~22.61）与PPD 的发生相关。结论 北京地区哺乳期妇女存在膳食摄入过量、摄入不足及膳食失衡问题,PPD的发生与膳食过量和膳食失衡相关,应针对膳食相关危险因素加强干预,预防和减少产后抑郁的发生。
Abstract
Objective To evaluate dietary quality of lactating women 6 months after delivery and examine the association between dietary quality and postpartum depression (PPD). Methods An epidemiological investigation was conducted on 401 women who had registered after delivery at 6 community health service centers in Beijing from June to July 2019. Basic and childbirth information were obtained through records extraction from Maternal Health Manual and Community Maternal and Child Health Records. Follow-up was conducted 6 months after delivery to gather information on breastfeeding and maternity care. The Edinburgh Postnatal Depression Scale (EPDS) and a validated food frequency questionnaire (FFQ) were used to assess the status of PPD and dietary intakes, respectively. Dietary quality was evaluated using the Dietary Balance Index for Lactating women (DBI-L). Results Of the postpartum women, 26.40% were depressed based on the EPDS cut-off score (≥13). About 77.56% had overall imbalanced dietary intake, with a high proportion of excessive intake (65.84%) and inadequate intake (41.15%). Compared to the non-PPD women, PPD women had poorer overall dietary balance (P=0.001), and more severe excessive intake (P<0.000) and inadequate intake (P=0.04). PPD women also had significantly lower intake of vegetables and fruits (P<0.01) and higher intake of cereal (P<0.01) compared to the non-PPD women. Maternal excessive intake (moderate excessive intake OR=5.855, 95% CI: 2.647-12.950; high excessive intake OR=5.928, 95% CI: 2.510-14.00) and dietary overall imbalance (OR=7.924, 95% CI: 2.777-22.61) were associated with the occurrence of PPD. Conclusion Lactating women in Beijing had imbalanced dietary intake, which was associated with PPD. Strengthening dietary intervention focusing on relevant risk factors is crucial to preventing PPD
关键词
哺乳期妇女 /
产后抑郁 /
膳食质量 /
膳食平衡指数
Key words
lactating women /
postpartum depression /
dietary quality /
dietary balance index
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基金
中国医学科学院医学与健康科技创新工程项目（No.2019-I2M-2-007）
