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妊娠结局与不良情绪的相关性研究
作者:黄晓洁1  杨俊波2  李琳1 
单位:1. 湖北省襄阳市中心医院 妇科, 湖北 襄阳 441021;
2. 湖北省襄阳市中心医院 心胸外科, 湖北 襄阳 441021
关键词:焦虑 抑郁 生活事件 妊娠结局 影响因素 
分类号:R714.7
出版年·卷·期(页码):2015·34·第二期(226-230)
摘要:

目的:了解孕妇焦虑、抑郁和生活事件现状,探讨孕妇焦虑、抑郁和生活事件等不良情绪与妊娠结局的关系.方法:采用前瞻性队列研究设计,以2012年1月至2013年6月期间在襄阳市中心医院进行孕期健康保健并有明确意向在该院分娩的孕妇作为研究对象,采用问卷调查收集孕妇焦虑、抑郁和生活事件现状资料并追踪其妊娠结局,采用Spearman相关系数描述孕妇焦虑、抑郁和生活事件与孕妇妊娠结局的相关关系,采用多因素Logistic回归分析筛选影响孕妇不良妊娠结局发生的相关因素.结果:323名孕妇中,存在焦虑情绪18人(5.6%),其中状态焦虑者13人(4.0%),特质焦虑者5人(1.6%);有95名(29.4%)孕妇存在抑郁情绪,有89名(27.6%)孕妇表现为有抑郁倾向;孕妇生活事件总分超过临界值处于应激状况的孕妇占24.2%,主观事件处于应激状况的孕妇占7.8%.孕妇状态焦虑、特质焦虑与低出生体重之间存在正相关关系(P <0.05);孕妇生活事件OE2评分与孕妇早产、低出生体重之间呈正相关关系,与新生儿阿斯评分之间呈负相关关系(均P <0.05);孕妇生活事件OE3评分与新生儿阿斯评分之间呈负相关关系(P=0.032).孕妇不良妊娠结局影响因素的多因素Logistic回归分析显示,影响孕妇发生不良妊娠结局的主要危险因素有高龄、孕期感染史、孕期用药史、孕期特质焦虑情绪、孕期抑郁情绪.结论:孕妇孕期焦虑、抑郁、生活事件等不良情绪普遍存在,且与不良妊娠结局存在一定相关性,孕期特质焦虑情绪和抑郁情绪是发生不良妊娠结局的重要危险因素.

Objective: To understand status of pregnant women in anxiety, depression and life events, and to explore the relationship between anxiety, depression, life event and pregnancy outcome. Methods: A prospective cohort study design was used, included the pregnant women who took health care during the period from 2012 January to 2013 June in Xiangyang Center Hospital and had a clear intention to give birth in the hospital as the research object. and the questionnaire survey was used to collect pregnant anxiety, depression, life events status information and the pregnancy outcomes followed. Spearman correlation coefficient was used to describe the relationship between maternal anxiety, depression, life events and pregnancy outcome. Multivariate Logistic regression was used to analyses the factors influencing the occurrence of screening of pregnant women with adverse pregnancy outcome. Results: Among the 323 pregnant women, 18 was anxiety(5.6%), wherein the state anxiety was 13 (4%), and trait anxiety was 5(1.6%). 95 (29.4%) pregnant women were with depressive emotion, 89 (27.6%) women were prone to depression. Life events score exceeded a critical value in the stress status of pregnant women accounted for 24.2%, subjective events in stress status of pregnant women accounted for 7.8%. There was a positive correlation between the pregnant state anxiety, trait anxiety and low birth weight (P <0.05). Positive correlation was found between OE2 score and the pregnant woman life events of premature delivery, low birth weight, negative relationship was found between the score and neonatal aspen (P <0.05). There was a negative correlation between OE3 score and neonatal maternal life events score (P=0.032). Logistic multi factors regression was used to analyses the factors influencing the outcome of pregnancy, the main risk factors of adverse pregnancy outcomes were infection history, medication history, maternal trait anxiety, depression during pregnancy. Conclusion: Maternal anxiety, depression, life events and other negative emotions exist, and there is a certain correlation with adverse pregnancy outcomes. Trait anxiety and depression during pregnancy are important risk factors for adverse pregnancy outcomes.

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