Japanese

Title	母乳育児と母親のこころの問題 - 母親のニーズと不安の原因 -
Subtitle	総説 第34回日本母乳哺育学会学術集会 シンポジウム (1)
Authors	多田克彦
Authors (kana)
Organization	独立行政法人国立病院機構岡山医療センター産婦人科 産科医長
Journal	日本母乳哺育学会雑誌
Volume	14
Number	1
Page	80-88
Year/Month	2020 /
Article	報告
Publisher	日本母乳哺育学会
Abstract	「要旨」出産前後の母親の気分障害と母乳育児との関係についての報告は多い. 最近のレビューによれば, 出産前の不安と母乳育児との関係性については今後の研究を待たねばならないが, 産後うつ病は母乳育児の負の因子として間違いないようであり, 出産後の不安との関連も無視できないようである. 我々は, 平成21, 22年度国立病院機構共同臨床研究(5施設中4施設がBFHを標榜)で収集したデータを基に, 分娩前後のこころの状態と母乳育児に焦点を当て研究し, 母乳育児を希望して来院した母親とそうでない母親とではSTAIを用いて測定した出産後の不安の危険因子が異なることを示した. 前者では「母乳育児を続けていく自信ができなかった」, が最も大きな危険因子であり, 後者では母乳育児に関連する項目は抽出されなかった. この結果は, 一人一人の母親に対して個別化したケアを提供することの必要性を再認識させてくれる.
Practice	臨床医学：一般
Keywords	baby friendly hospital, breastfeeding, postpartum anxiety, postpartum depression

English

Title	Relationship between postpartum mood disorder and breastfeeding
Subtitle
Authors	Katsuhiko TADA
Authors (kana)
Organization	Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center
Journal	The Journal of the Japanese Society for Breastfeeding Research
Volume	14
Number	1
Page	80-88
Year/Month	2020 /
Article	Report
Publisher	The Japanese Society for Breastfeeding Research
Abstract	Many studies have addressed the relationship between perinatal mood disorders and breastfeeding. One recent systematic review found insufficient evidence to clarify the association between prenatal anxiety and breastfeeding. Various factors affect how postpartum depression relates to breastfeeding (e.g., initiation, duration, exclusivity, difficulties, self-efficacy). Results have shown depressive symptoms in the postpartum period negatively influence infant feeding outcomes. Moreover, several studies have emphasized the great importance of postpartum anxiety's impact on breastfeeding. We conducted a National Hospital Organization network group multi-center study in 2009-2011 to explore the risk factors of postpartum mood disorders of mothers who delivered at one of the participant hospitals (four of five such facilities advocate Baby Friendly Hospitals). The Edinburgh Postpartum Depression Scale (EPDS) was used to assess depression symptoms at 1 month postpartum, and the State-Trait Anxiety Inventory (STAI) was used to assess postpartum anxiety approximately 1 week post-delivery. A high STAI score was the main risk factor for an EPDS score >=9 points, which is considered to indicate a high risk of postpartum depression. We divided the 254 participant mothers into two groups - those who wanted to breastfeed (n=194) and those who did not (n=60) - to assess causes of postpartum anxiety (STAI score >=45 points). In the former group, lack of confidence in continuing breastfeeding was the most common contributing factor, though no items related to breastfeeding were extracted in the latter. These results underscore the importance of providing personalized care suited to each mother.
Practice	Clinical medicine
Keywords	baby friendly hospital, breastfeeding, postpartum anxiety, postpartum depression

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