Abstract: Background　Having a second child increases the incidence of maternal perinatal anxiety or depression.The relationship between pre- and postnatal depression has always been a research focus.Mindfulness-based yoga can alleviate the maternal perinatal anxiety and depression.It is widely used in European countries and the America.However，there are few research on its effectiveness and feasibility in China.Objective　The aim of this study was to determine the effect of mindfulness-based yoga group intervention on maternal postpartum depression following the second childbirth.Methods　 By use of convenience sampling，86 women undergoing routine outpatient prenatal examination during the second pregnancy in a tertiary general hospital in Changsha，China，were enrolled between September 2017 and March 2018.They were equally divided into the control group，and intervention group by use of a random number table，receiving 6-week routine mental health nursing care，6-week routine mental health nursing care with mindfulness-based yoga group intervention，respectively.Pre- and post-intervention Zung Self-rating Anxiety Scale（SAS） scores，Edinburgh Postnatal Depression Scale（EDPS） scores，and serum cortisol levels in both groups were collected.Two groups were given a 6-week postpartum follow-up，during which the incidence of postpartum depression（EPDS>9.5 points） was obtained.Results　Altogether，38 cases in the control group and 40 in the intervention group completed the intervention and survey.No significant differences were found between two groups at baseline（P>0.05）．However，post-intervention mean scores of SAS，and EPDS and serum cortisol level in the intervention group were significantly lower than those of the control group（P<0.05）．Moreover，the incidence of postpartum depression in the intervention group was lower than that of the control group（P<0.05）．Conclusion　Mindfulness-based yoga group interventions have a good impact on the physiological and psychological state in women having a second childbirth，and also is effective in reducing the risk of having postpartum depression.

Key words: Depression, postpartum；Yoga；Mindfulness；The second pregnancy；Pregnant women；Hydrocortisone；Treatment outcome

摘要： 背景　二胎孕妇的焦虑抑郁发生率高于一胎孕妇，产前抑郁与产后抑郁的关系一直是国内外的研究重点。正念瑜伽可以缓解孕妇妊娠期的焦虑抑郁情绪，目前在欧美地区应用广泛，但在我国针对其有效性和可行性的研究较少。目的　探讨团体正念瑜伽对二胎孕妇产后抑郁的干预效果。方法　于2017年9月—2018年3月，采用方便抽样法选取在长沙市某三级综合医院门诊行产前检查的二胎孕妇86例，采用随机数字表法将其分为对照组和干预组，每组43例。对照组实施常规心理护理，干预组在常规心理护理基础上进行正念瑜伽训练，两组均干预6周。比较两组干预前和干预6周后的焦虑自评量表（SAS）评分、爱丁堡产后抑郁量表（EPDS）评分及血清氢化可的松水平；随访至产后第6周，比较两组的产后抑郁（EPDS>9.5分）发生率。结果　对照组和干预组分别有38、40例孕妇完成了干预和调查。干预前两组患者基线临床资料比较，差异无统计学意义（P>0.05）。干预后干预组SAS评分、EPDS评分及血清氢化可的松水平低于对照组（P<0.05）。产后6周，干预组产后抑郁发生率低于对照组〔12.5%（5/40）比36.8%（14/38）；χ2=6.27，P<0.05〕。结论　团体正念瑜伽可影响二胎孕妇妊娠期生理和心理状况，减少产后抑郁的发生。

关键词: 抑郁症, 产后；瑜伽；正念；二胎妊娠；孕妇；氢化可的松；治疗结果