産後うつ状態に影響を及ぼす背景因子についての縦断的研究(第二報) : 産後うつ状態と対児感情・児への愛着との関連  [in Japanese] Relationships among mother's postpartum emotional state, her own attachment style and attachment formation toward her baby (Part 2)  [in Japanese]

本研究では,産後うつ状態が児への愛着・対児イメージに与える影響を明らかにし,助産師が行う妊産婦の育児支援のための基礎資料とすることを目的とし,調査を実施した。妊娠末期から,産後5日,1ヵ月,3ヵ月までの追跡調査が可能であった妊産婦58名を分析の対象とした。質問紙は,1.対象の属性・背景に関する質問紙,2. SDS, 3.産褥期母親愛着尺度(Nagata),4. PBI, 5. IWM:対人関係における愛着スタイルの評定尺度を実施した。SDS得点が40点以上をうつ状態と評価し,産後5日・産後1ヵ月・産後3ヵ月にかけてうつ状態が持続していたのは,21名(36.2%)であった。以下,うつ状態が持続していた21名をうつ持続群,他37名を非うつ持続群とし,比較検討した。うつ持続群は非うつ持続群に比べ,PBIのCA得点が高く,OP得点が低かった。また,対児感情の接近得点が低く,回避得点が高かった。さらに,産褥期愛着尺度の愛着因子が低く,接触・不安因子が高かった。うつ持続群において,対児感情尺度の接近得点は1〜3ヵ月にかけて,回避得点は産後5日〜1ヵ月にかけ上昇し,3ヵ月においても高値を持続していた。

This study explored their postpartum emotional state and attachment formation toward their baby. The subjects of this study were fifty eight women in late pregnancy who gave written informed consent. They were asked to fill out some questionnaires at 8 to 9 months of pregnancy, five days after birth, one month after birth, and three months after birth. Self-rating Depression Scale (SDS; Zung) and Feeling toward Baby Scale (FBS; Hanazawa) were administered four times. Parental Bonding Instrument (PBI; Parker) was administered at 8 to 9 months of pregnancy and Internal Working Model (IWM; Shaver) at one month after birth. Postpartum Maternal Attachment Scale (Nagata) was administered at four month after birth. The subjects were divided into two groups; the continuously high SDS group (CHSG) and the non CHS group (NCHSG). The CHSG is consisted of 21 subjects who had scored continuously high (40 points and above) in SDS. The NCHSG is consisted of the rest of the subjects (n=37). The score of negative scale of FBS was higher in the CHSG group than in the NCHSG at one month and three months after birth. And the score of positive scale of FBS was lower in the CHSG than in the NCHSG group at one week and one month, and three months after birth. The score of Core maternal attachment scale of PMAS was lower in the CHSG than in the NCHSG at three months after birth. And the score of Anxiety regarding children scale of PMAS was higher in the CHSG group than in the NCDG at three months after birth.