試管嬰兒治療成功之婦女的產後憂鬱研究

產後憂鬱與過去懷孕經驗有關。經由接受試管嬰兒治療成功生產的婦女，因過去不孕、治療及懷孕的特殊經驗而有不同的心理社會反應，這些婦女的心理社會反應與產後憂鬱之間的關係，值得探討。本研究目的在探討接受試管嬰兒治療成功婦女其母育信心、家庭功能、社會支持、壓力感受及產後憂鬱狀況，並另選取一組自然懷孕婦女作為比較。研究樣本以立意取樣方式，自中部地區某一經衛生署評鑑合格之不孕症研究中心接受試管嬰兒治療成功生產的婦女為研究對象，並以中部某一醫學中心婦產科門診自然懷孕之初產婦為對照組，收取每組樣本數各60名。本研究採結構式問卷法，問卷內容包括家庭功能量表、母育信心量表（MCQ）、壓力知覺量表（PSS）、社會支持調查表（ISEL）以及貝氏憂鬱量表。資料分析以SPSS PC（＋）10.0版套裝軟體，以百分比、平均數、標準差、t檢定、卡方檢定、單因子變異量分析、皮爾森相關及逐步迴歸進行分析。 研究結果發現：兩組產後憂鬱症狀之前十項症狀相似，接受試管嬰兒治療成功婦女在產後憂鬱量表中之身體及營養狀況症狀比自然懷孕婦女高。接受試管嬰兒治療成功婦女的產後憂鬱受「新生兒妊娠週數」、「生產方式」、「接受IVF治療次數」、「家庭功能」、「社會支持」、「壓力知覺」因素的影響。 接受試管嬰兒治療成功婦女產後憂鬱的最佳預測因子為「社會支持」、「壓力知覺」及「接受IVF治療次數」，此三變項可解釋總變異量的49.4﹪。 本研究結果顯示接受試管嬰兒治療成功婦女產後雖抱怨較多的身體及營養狀況症狀，但其心理社會健康狀態和自然懷孕婦女沒有顯著差異，此現象值得進一步探討。且本研究結果在臨床上可提供接受試管嬰兒治療之不孕症婦女在產後的持續照護。

Postpartum depression is related to past pregnancy experience. Those who had received in vitro fertilization/ embryo transfer (IVF/ET) as a participant in a program would take different kinds of psychosocial behaviors due to the special experience of infertility, treatment and pregnancy. Relationships between these women’s psychosocial response and the postpartum depression are interesting and need further exploration. The purpose of this study is to discuss mother-feeding confidence, family function, social support, stress perception and postpartum depression of mothers who had received IVF/ET as part of a program, compared with women who had natural child-bearing. Methods: 60 patients came from a high-technologic study IVF/ET clinic center in the middle of Taiwan, compared with 60 first-natural birth women in a OBS/GYN clinic from a medical center also in the middle of Taiwan. They were tested by a family function questionnaire, Maternal Confidence Questionnaire (MCQ), Perceived Stress Scale (PSS), Interpersonal Support Evaluation List (ISWL) and the Beck Depression Inventory (BDI) questionnaire. All data were analyzed with SPSS PC (+) 10.0 edition software. Data analyses included descriptive statistics, t-test, chi-square, ANOVA, Pearson’s product-moment correlation, and stepwise regression. Results: there were no significant differences between the first 10 symptoms. The physical and nutritional conditions are higher in women who were treated by an IVF/ET center compared with those who were treated in the manner of a natural pregnancy. The results revealed that their postpartum depression is related to weeks of pregnancy, method of delivery, time of receiving IVF/ET, family function, social support, stress perception. The best forecast factors are social support, stress perception and time of receiving IVF/ET. Conclusion: there is no significant difference in psychosocial state between women receiving IVF/ET program and natural pregnancy, although there are more complaints about the physical and nutritional conditions. This problem needs more evaluation and discussion. The results would be a reference for additional and better care of women who received the IVF/ET program.