fa نشانه های اضطراب و افسردگی و عوامل مرتبط با آن در زنان باردار و شیرده طی پاندمی کووید-19 در شهر رشت سال 1399 اپیدمیولوژی Epidemiology پژوهشي-کامل Research(Original) <span style="font-size:12pt"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span b="" lang="FA" style="font-family:" zar="">گستردگی کووید-19 می‌تواند بر شکل</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">گیری اضطراب و افسردگی و پیامدهای نامطلوب آن در دوران پری‌ناتال اثرگذار باشد. هدف از این مطالعه، ارزیابی نشانه</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">های اضطراب و افسردگی و عوامل مرتبط با آن در زنان باردار و شیرده طی پاندمی<b> </b>کووید-19 بود.<span style="color:#0e101a"></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span b="" lang="FA" style="font-family:" zar="">این مطالعۀ مقطعی شامل 450 مادر باردار و شیرده در رشت، گیلان از خرداد تا آبان 1399 طی موج دوم و سوم کووید-19 انجام شد. داده</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">ها با نمونه</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">گیری در دسترس و </span><span b="" lang="FA" style="font-family:" zar="">چند مرحله</span><span b="" lang="FA" style="font-family:" zar="">‌</span><span b="" lang="FA" style="font-family:" zar="">ای در</span><span b="" lang="FA" style="font-family:" zar=""> یک مرکز آموزشی درمانی مرجع و <span style="letter-spacing:-.1pt">مراکز خدمات جامع سلامت</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"> گردآوری شد.</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"> نشانه</span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">‌</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt">های اضطراب و افسردگی به ترتیب با استفاده از پرسشنامۀ اختلال اضطراب</span></span><span b="" lang="FA" style="font-family:" zar=""> فراگیر-7</span> <span b="" lang="FA" style="font-family:" zar="">و پرسشنامۀ سلامت بیمار-9 ارزیابی شد. جهت تحلیل داده‌ها از آمار توصیفی و آمار تحلیلی (آزمون </span>t<span b="" lang="FA" style="font-family:" zar=""> مستقل، آزمون کای‌دو و رگرسیون لجستیک) استفاده شد.</span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> شیوع اضطراب فراگیر در زنان باردار 9/16 درصد و در زنان شیرده 10/7 درصد بود (0/057=</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">P</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">). شانس نشانه</span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">های افسردگی در زنان باردار 6/64 برابر زنان شیرده بود </span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">(21/15&nbsp;</span></span><span lang="AR-SA" style="line-height:90%">&ndash;</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar=""> 2/08 :</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">CI</span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar=""> 95 درصد، 6/64=</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">OR_Adj</span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">).</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> نشانه</span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">های <span style="letter-spacing:-.1pt">اضطراب- افسردگی در زنان باردار بیش</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">تر از زنان شیرده بود (6/2 در برابر 0/9 درصد، 0/002=</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.1pt">P</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">). اضطراب فراگیر با بی</span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">‌</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">کار</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> بودن همسر، داشتن بیماری</span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">های مزمن، طول </span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">مدت فکرکردن به کووید-19 و داشتن افراد پرخطر در خانواده و نشانه</span></span><span b="" lang="FA" style="font-family:" zar="">‌</span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">های افسردگی با باردار بودن، تحصیلات پایین</span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">تر همسر و داشتن افراد پرخطر در خانواده ارتباط معنی</span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">دار داشت (</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">0/05</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:90%"><span b="" style="font-family:" zar="">></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">P</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">).</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span b="" lang="FA" style="font-family:" zar="">این مطالعه نشان داد در پاندمی<b> </b>کووید-19، مادران باردار و شیرده، نشانه</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">های اضطراب بیش‌تری نسبت به افسردگی داشتند و نشانه</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">های افسردگی در زنان باردار بیش‌تر از مادران شیرده بود. این نتایج بر اهمیت پایش سلامت روان برای بهینه</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">کردن کیفیت مراقبت پری</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">ناتال طی اپیدمی</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">ها/ بحران</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">های اجتماعی تأکید می</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar="">‌</span></span><span b="" lang="FA" style="font-family:" zar="">کند.</span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span></span> <span style="font-size:12pt"><span style="line-height:135%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:135%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%">The spread of COVID-19 can cause anxiety and depression and lead to adverse outcomes in perinatal period. This study aimed to evaluate anxiety and depression symptoms and associated factors in pregnant and breast feeding women during the COVID-19 pandemic.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:135%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:135%"><span arial="" style="font-family:">Materials and methods:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%">This cross-sectional study included 450 pregnant and breast feeding women in Rasht, Iran during the second and third wave of COVID-19 (June-November 2020). Data were collected using convenience</span></span></span><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%"> and multi-stage </span></span></span><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%">sampling in a teaching hospital and six healthcare centers. Anxiety and depression were evaluated by Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. Descriptive statistics and analytical statistics, including independent t-test, Chi-square test, and logistic regression were used to analyze the data.</span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:135%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:135%"><span arial="" style="font-family:">R</span></span></span></b><b><span style="font-size:10.0pt"><span style="line-height:135%"><span arial="" style="font-family:">esults:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%">Generalized anxiety</span></span></span><span style="font-size:10.0pt"><span style="line-height:135%"> was seen in 16.9% of pregnant women and 10.7% of </span></span><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%">breast feeding <span style="letter-spacing:-.1pt">women (P=0.057)</span></span></span></span><span style="font-size:10.0pt"><span style="line-height:135%"><span style="letter-spacing:-.1pt">. Expectant mothers were 6.64 times more likely to have depressive symptoms compared</span></span></span><span style="font-size:10.0pt"><span style="line-height:135%"> with </span></span><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%">breast feeding </span></span></span><span style="font-size:10.0pt"><span style="line-height:135%">women (OR_Adj=6.64, 95% CI: 2.08-21.15). Comorbid anxiety-depressive symptoms were higher in pregnant women than breast feeding women (6.2% vs. 0.9%, P=0.002). A</span></span><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%">nxiety</span></span></span><span style="font-size:10.0pt"><span style="line-height:135%"> was found to be significantly associated with an unemployed husband, having chronic diseases, thinking about COVID-19, and high-risk individuals in the family (P<0.05).</span></span><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%"> Also, there was a significant relationship <span style="letter-spacing:-.2pt">between depression</span></span></span></span><span style="font-size:10.0pt"><span style="line-height:135%"><span style="letter-spacing:-.2pt"> and pregnancy, less educated husband, and high-risk individuals in the family (P< 0.05).</span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:135%"><span style="vertical-align:top"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:135%"><span arial="" style="font-family:">Conclusion:</span></span></span></b> <span style="font-size:10.0pt"><span style="background:white"><span style="line-height:135%">In this study, pregnant and breast feeding women showed more anxiety symptoms than depression symptoms during COVID-19. Expectant mothers were more likely to have depressive symptoms than breast feeding women. These results emphasize the importance of mental health monitoring to improve perinatal-care quality during epidemics/social crises.</span></span></span><i><span style="font-size:10.0pt"><span style="line-height:135%"><span style="color:black"></span></span></span></i></span></span></span></span><br> <span style="font-size:12pt"><span style="tab-stops:121.45pt"><span new="" roman="" style="font-family:" times=""><b><i><span style="font-size:10.0pt"><span style="color:black"></span></span></i></b></span></span></span> اضطراب, افسردگی, بارداری, شیردهی, کووید-19 anxiety, depression, pregnancy, breastfeeding, COVID-19 62 74 http://jmums.mazums.ac.ir/browse.php?a_code=A-10-6327-2&slc_lang=fa&sid=1 Parvaneh Rezasoltani پروانه رضاسلطانی rezasoltani49@gmail.com 1003194753284600144117 1003194753284600144117 No Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran استادیار، گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی گیلان، رشت، ایران Saman Maroufizadeh سامان معروفی‌زاده saman.maroufizadeh@gmail.com 1003194753284600144118 1003194753284600144118 Yes Assistant Professor, Department of Biostatistics, School of Health, Guilan University of Medical Sciences, Rasht, Iran استادیار، گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی گیلان، رشت، ایران Farzaneh Sheikholeslami فرزانه شیخ‌الاسلامی farzaneh.sheikh@yahoo.com 1003194753284600144119 1003194753284600144119 No Psychiatric Nursing Instructor, Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran مربی روان پرستاری، گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی گیلان، رشت، ایران Masoumeh Malekzadeh Haghighi معصومه معصومه ملک‌زاده حقیقی baharmalekzadeh025@gmail.com 1003194753284600144120 1003194753284600144120 No MSc Student in Midwifery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran دانشجوی کارشناسی ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی گیلان، رشت، ایران