Postpartum Mental Health among Young Women--论文代写范文精选

青少年怀孕的定义是在20岁以下的女性怀孕,虽然在美国,这个词通常指18岁以下的女孩身上。青少年怀孕是一个世界性的社会问题，在发展中国家发病率是明显的。结婚的平均年龄是14岁,第一次怀孕的平均年龄是16岁。下面的essay代写范文进行详述。

Abstract
Background: A number of studies have highlighted the physical health problems associated with adolescent pregnancy in Saudi Arabia , However there were few studies dealing with the postpartum psychiatric disorders .The study aims to determine the prevalence of postpartum psychological distress and to evaluate the associated risk factors in a sample of primigravid young women in Al Ahsa region, Saudi Arabia. 
Methods: We assessed the prevalence of postnatal mental health in 190 young mothers attending the maternity hospital using general health questionnaire. We also assessed the relationship between socio-demographic, psychiatric and obstetric risk factors and the mental health. Results: The percent of women with psychological distress was 35.2%. Significant risk of psychological distress was associated with several socio-demographic, psychiatric and obstetric risk factors. Only four items were found to be significant predictors of postpartum psychological distress; low family income, poor husband support, birth of female baby and gestational diabetes. Conclusions: These results highlighted importance of screening for psychological distress and its associated risk factors in the implementation of proper perinatal care for the pregnant Saudi adolescents. 
Key Words: Teenage pregnancy; Postnatal psychiatric disorders; Risk factors

Introduction
Teenage pregnancy is defined as pregnancy in women under the age of 20, although in the United States, the term usually refers to girls younger than 18 years. Teenage pregnancy is a worldwide social problem and its incidence shows marked variation amongst developing countries.(1-2) In Saudi Arabia, the birth rate per 1000 females aged 15–19 is 114. The average age at marriage is 14 years, and average age at first pregnancy is 16 years.(3) An increased prevalence of anemia, low-birth-weight (LBW) infants, pregnancy-induced hypertension (PIH) and cesarean section was found in young Saudi pregnant women.(4-7) 

The birth of a child especially the first can be a joyous and exciting time, but following childbirth, some women may experience postpartum disorders such as the baby blues, postpartum depression (PPD), birth-related post-traumatic stress disorder, postpartum anxiety and/or panic disorder, postpartum obsessive-compulsive disorder (OCD) or rarely postpartum psychosis (PPP). Postpartum psychiatric disorders have been the subject of an increasing number of publications.(8-10) The majority of these studies are Western. In developing countries, many studies have examined the occurrence of postpartum psychiatric disorders and the focus was on prenatal and delivery care and on women’s medical and obstetrical problems and on the baby’s wellbeing.(11-13) The authors of this study assumed hypothesis that the risk of developing postpartum psychiatric disorders is independent of adverse socio demographic, psychiatric or obstetric risk factors. The aim of this study was to detect the prevalence of postnatal psychological distress in a sample of primigravid teenagers in Al Ahsa region, Eastern Province, Saudi Arabia. Also the study aims to highlight the ability of different risk factors in prediction of postpartum psychological distress.

Methods 
This study was conducted at Al Ahsa Maternity hospital, Saudi Arabia Al-Ahsa, Saudi Arabia; which is the largest province in the Eastern region with a population of nearly 1 million with diverse socioeconomic backgrounds.(2) Maternal services are provided by Al-Ahsa Maternity Hospital and a network of primary health care centers (PHCCs). The antenatal care clinics provide regular care for pregnant women with the use of the classic 13 visits schedule throughout pregnancy. The postnatal visits were conducted monthly after birth and at times of neonatal vaccination.

Study design 
The women completed a questionnaire designed for this study that covered socio- demographic (educational This work is licensed under a Creative Commons AttributionNo Derivative Works 2.5 India License Online Journal of Health and Allied Sciences Peer Reviewed, Open Access, Free Online Journal Published Quarterly : Mangalore, South India : ISSN 0972-5997 Volume 10, Issue 4; Oct-Dec 2011 2 level and occupation of the wife and husband, current residence and level of income) medical, especially obstetrical (antenatal: pregnancy induced hypertension, gestational diabetes, antepartum hemorrhage, anemia, premature rupture of membranes; Perinatal: birth weight, gestational age at birth, mode of delivery, newborn gender and health status; postnatal: postpartum hemorrhage, fever and continence problems) psychiatric (quality of marital life, husband support, stressful live events in the last 6 months, family and past history of psychiatric illness). 

The women also completed the General Health Questionnaire (GHQ), a widely used, valid and reliable indicator of psychological distress and a predictor of psychological distress . This instrument has previously used in screening for postpartum psychiatric morbidity.(14-15) The 12-item Arabic version was used in this study. The cut-off score of 12 was adopted a priori to identify cases.(16) Sensitivity and specificity was 0.83 and 0.80 respectively. The total discriminatory powers of the GHQ-12 were approximately 86%, and have a significant concurrent validity.

Results
A total of 205 young women were invited to take part in the study. The GHQ was completed for 190 women (the response rate was 92.7%). the mean age was 17.7 years, ranging from 15.7 to 19.8. All of them were married and their delivery was conducted at hospital Point prevalence of psychological distress The prevalence of psychological distress was (35.2%). The mean score of GHQ in the cases was 22.81± 6.44 (range 14- 35). On the other hand the mean score in the non cases was 8.98 ± 1.83 (range 5-12), with significant statistical difference. (P< 0.01) Table 1 summarizes the socio-demographic and psychiatric characteristics of the study sample. 

The majority of mothers (72.1%) had achieved either elementary or secondary levels of education and 78.4% were housewives. Nightly-two women (48.4%) were living in urban areas. Only 31.6% of their husbands had achieved a higher level of education and 5.3 % had unstable jobs. The majority of cases had good quality of married life; however 31 (16.3% ) of them described this relation as poor and 27.8 % of the sample lack the assistance from husband, 17.9 % had stressful life events during the previous 6 months, 21.6 % had previous psychiatric disorders and 26.8 % had a family history of psychiatric disorders. (Table 1) Table 2 summarizes the obstetric characteristics of the study sample. Regarding the course of pregnancy, nearly half of the sample reported anemia (43.2%) whereas 24.2% had gestational diabetes, others include: hypertension, premature rupture of membranes and antepartum hemorrhage in 17.9, 11.1 and 5.3% respectively. The majority of participants reported a cesarean mode of delivery ending in a full term newborn with average birth weight and appropriate Apgar scoring, moreover the newborns had a comparable sex distribution (55.3 % males and 44.7 % females) but, one tenth of the newborns (13.2%) were admitted to the NICU. The most common postnatal complications in the sample were post partum fever (27.4%) followed by continence problems (13.7%) and post partum hemorrhage (5.8%).

Discussion
Since the mid-20th century, Saudi Arabia with its oil riches has been in a socio-demographic, cultural, and economic transformation. In the last four decades the population has increased from 4 million (5% urban, 70% illiterate) to 28 million (80 % urban, 81% literate) with over 50% of the population in Saudi Arabia is now less than 25 years of age.(17) This fast transformation and the complex social pattern of the country caused various conflicts which may affect young women. They are more reluctant to marry at an earlier age, choosing to pursuit higher education and careers, less accepting of having their roles restricted to motherhood. The consequences of these problems would have a substantial effect on the mother, her child and the family.(18) This study is one of very few researches looking at postpartum psychological distress among women from Middle East.(19-21) Moreover, to our knowledge, it is the first to show the prevalence and putative risk factors in young mothers.(论文代写)

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