| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 101 === Background:
Depression is one of the leading diseases in this century. Postpartum depression (PPD) is a common disorder after delivery. Maternities suffer from PPD often ignore necessary care for their babies and resulting in injuries. Therefore, PPD is an important health issue, but research focusing on this issue was rare.
Objectives:
The main purpose of this study was to explore the association between PPD and its association between maternities and their babies. Results of this study can be used to assist our understanding about PPD and its consequences.
Methods:
This study is a retrospective cohort study using the claim data files from the 2003-2006 National Health Insurance Research Database (NHIRD) for further data analysis. Samples of the study were selected from women who had no prenatal depression six months prior to delivery dates between July 2003 and June 2004. Among the samples the study group was composed of 1,228 women who were identified to have postpartum depression with ICD-9-CM diagnosis codes of PPD at least once and were using postpartum antidepressants and antipsychotics within six months after the delivery, while the control group was chosen from women who had no record of ICD-9-CM diagnosis code or using antidepressants and antipsychotics within six months after the delivery, total of 87,088 women. After applying Propensity Score Matching method with basic characteristics including age, socioeconomic status, urbanization of residential areas, production methods and infant congenital diseases in a 1:1 match, picking pairs with similar characteristics between the study and the control groups, a total of 2,418 people were selected with 1,029 people in each group. Further, the ACGs (Adjusted Clinical Groups) system software was used to measure health condition of maternity suffered from PPD within six months after the delivery and that of their infants. The reaction from the PPD on the infants was observed at six months, one year, or two years after birth.
Results:
The average total health care utilization of the babies at six months, one year, and two years after birth from the study group were 2.69 times (P <0.0001), 1.65 times (P <0.0001) and 1.38 times (P <0.0001) more than those of the babies from the control group, respectively. PPD not only affects health status of babies, but also affects the health status of the mothers who suffer this disorder. Mothers who suffered from PPD after 6 months, one year, two years after delivery had an average total health care utilization of 3.35 times (P<0.0001), 2.48 times (P<0.0001), and 2.01 times (P<0.0001) more than those of the mothers from the control group, respectively.
Conclusions:
This study shows the association between PPD, health status of maternity and baby. Maternities suffer from PPD within six months affects health status of maternities and their babies at the same time and impact is reflected immediately at the sixth month after delivery. I suggested perform the postpartum depression screening for postpartum depression in this period when maternity return gynecology clinic or pediatrics clinic with her baby. The patients could be found and treated early.
Key Words: postpartum depression, PDP, health status of maternity, health status of baby, Resource Utilization Bands.
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