二胎瘢痕子宫孕妇孕期抑郁状况及影响因素分析

周金英; 孙杨芳; 刘蓓; 胡春仙

doi:10.16766/j.cnki.issn.1674-4152.002015

二胎瘢痕子宫孕妇孕期抑郁状况及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.002015

杭州市妇产科医院产科，浙江杭州 310009

基金项目:

浙江省医药卫生科技计划项目 2020KY762

详细信息

通讯作者:
孙杨芳, E-mail: syfhz1972@163.com

中图分类号: R715.3 R395.6
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- 文章访问数: 134
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- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2020-06-05
- 网络出版日期: 2022-02-16

Depression and its influencing factors in second child pregnant women with cicatricial uterus

Obstetrics Department of Hangzhou Obstetrics and Gynecology Hospital, Hangzhou 310009, Zhejiang, China

摘要

摘要: 目的探讨二胎瘢痕子宫孕妇抑郁状况，并分析其影响因素, 为改善孕妇孕期的心理健康状况提供参考。方法选取2019年1月—2019年12月在杭州市妇产科医院、杭州市妇幼保健院产科门诊接受产前检查且拟在杭州市妇产科医院住院分娩的206例瘢痕子宫二胎孕妇作为研究对象，采用一般资料问卷、抑郁自评量表(SDS)、睡眠质量自评表(SRSS)、社会支持量表(SSRS)对研究对象进行调查, 并采用单因素及多元线性回归分析导致二胎瘢痕子宫孕妇抑郁的相关影响因素。结果二胎瘢痕子宫孕妇孕期抑郁总均分为(49.35±13.62)分; 单因素分析发现，不同年龄、家庭人均月收入、婆媳关系、妊娠合并症、睡眠质量、对胎儿性别期望、担忧产后恢复的孕妇抑郁得分差异具有统计学意义(均P＜0.05)。多元线性回归分析结果显示，家庭人均月收入、妊娠合并症、婆媳关系、睡眠质量、对胎儿性别期望、对产后恢复的担忧、社会支持水平是二胎瘢痕子宫孕妇抑郁的影响因素(均P＜0.05)。结论二胎瘢痕子宫孕妇孕期存在抑郁情绪，医护人员应对存在妊娠合并症、家庭经济收入低、存在孕期睡眠障碍的孕妇加强心理疏导和个性化教育与指导，并鼓励家庭成员给予孕妇积极的物质、信息和情感等支持，以改善二胎瘢痕子宫孕妇孕期抑郁情绪。
- 二胎 /
- 瘢痕子宫 /
- 抑郁 /
- 影响因素
Abstract: Objective To investigate the depression status of second child pregnant women with cicatricial uterus and analyse its influencing factors, so as to provide reference for improving the mental health of pregnant women during pregnancy. Methods Total 206 cases of pregnant women with cicatricial uterus who received prenatal examination in Hangzhou Obstetrics and Gynecology Hospital and Hangzhou Maternal and Child Health Care Hospital and planned to deliver in our hospital were selected as the research objects from January 2019 to December 2019. The general information questionnaire, self-rating depression scale, self-rating sleep quality scale and social support scale were used to investigate the subjects. The related influencing factors of depression in pregnant women (second child) with cicatricial uterus were analysed by single-factor and multiple linear regression. Results The total average score of depression in pregnant women with cicatricial uterus was (49.35±13.62) points. Univariate analysis showed that the depression scores of pregnant women with different age, family per capita monthly income, mother-in-law and daughter-in-law relationship, pregnancy complications, sleep quality, expectation of foetal gender and worry about postpartum recovery were statistically significant (all P < 0.05). Multiple linear regression analysis showed that family per capita monthly income, pregnancy complications, relationship between mother-in-law and daughter-in-law, sleep quality, expectation of foetal gender, worry about postpartum recovery and social support level were the influencing factors of depression in pregnant women (second child) with cicatricial uterus (all P < 0.05). Conclusion Pregnant women with cicatricial uterus have depression during pregnancy. Medical staff should strengthen psychological counselling and personalised education and guidance for pregnant women with pregnancy complications, low family income and sleep disorder during pregnancy, and encourage family members to provide material, information and emotional support to pregnant women to improve their depression during pregnancy.
- Second child /
- Cicatricial uterus /
- Depression /
- Influencing factors

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表 1 不同特征二胎瘢痕子宫孕妇SDS得分比较(x±s，分)

项目	类别	人数	抑郁得分	统计量	P值
年龄(岁)				3.202^a	0.043
	≤28	53	47.22±12.04
	29~34	98	49.14±13.76
	≥35	55	53.27±14.31
文化程度				1.010^a	0.389
	初中及以下	11	54.15±14.37
	高中/中专	50	49.92±13.04
	大专	54	49.34±12.11
	本科及以上	91	47.96±11.27
职业				0.643^a	0.526
	公务员	31	47.91±12.75
	企事业单位	49	49.33±13.82
	工人、服务业	90	50.49±14.93
	其他	36	49.82±14.31
家庭人均月收入(元)				3.963^a	0.021
	≤3 000	10	57.61±16.84
	3 001~6 000	137	49.75±13.90
	≥6 000	59	46.14±12.88
妊娠合并症				4.302^b	＜0.001
	有	82	56.10±13.95
	无	124	47.93±12.79
既往流产史				0.643^b	0.261
	有	112	49.97±13.57
	无	94	48.81±12.03
睡眠质量				9.587^a	0.000
	差	38	57.42±15.01
	一般	43	49.27±13.36
	好	125	46.92±12.11
婆媳关系				6.051^a	0.003
	差	31	55.43±15.94
	一般	76	50.11±14.27
	好	99	45.85±13.01
对胎儿性别期望				5.084^a	0.007
	男孩	59	49.68±13.70
	女孩	85	53.05±14.47
	无所谓	62	45.59±13.67
担忧产后恢复				3.219^b	0.001
	是	59	54.40±14.35
	否	147	48.03±12.19
注：^a为F值，^b为t值。

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表 2 自变量赋值表

项目	赋值方式
年龄	≤28岁=1，29~34岁=2，≥35岁=3
妊娠合并症	0=无; 1=有
家庭月收入	≤3 000元=1，3 001~6 000元=2，≥6 000元=3
睡眠质量	差=1，一般=2，好=3
婆媳关系	差=1，一般=2，好=3
对胎儿性别期望	男孩=(0，0)，女孩=(1，0)，无所谓=(0，1)
担忧产后恢复	无=0，有=1
社会支持得分	以实际值赋值

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表 3 二胎瘢痕子宫孕妇抑郁影响因素多元线性回归分析

自变量	B	SE	β	t值	P值
常数项	52.491	3.647		14.393	＜0.001
家庭人均月收入	-3.550	1.020	-0.178	-3.480	＜0.001
妊娠合并症	2.164	0.506	0.229	4.279	＜0.001
婆媳关系	-1.436	0.377	-0.124	-3.816	＜0.001
睡眠质量	-3.015	-0.649	-0.257	-4.645	＜0.001
担忧产后恢复	0.902	0.357	0.093	2.527	0.002
对胎儿性别期望	1.376	0.433	0.201	3.178	0.001
社会支持	-0.259	-0.086	0.144	-3.011	0.001

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参考文献(16)

[1]	VOLLRATH M E, SENGPIEL V, LANDOLT M A, et al. Is maternal trait anxiety a risk factor for late preterm and early term deliveries[J]. BMC Pregnancy Childbirth, 2016, 16(1): 286-289. doi: 10.1186/s12884-016-1070-1
[2]	KAUSAR N, AKRAM B, KHAN S D. Major depression in Jalal PurJattan, district Gujrat, Paki stan: Prevalence and gender differences[J]. J Pak Med Assoc, 2015, 65(3): 292-295. http://pdfs.semanticscholar.org/ba30/c9909e2015574ccc993ad484cabc5b8430d1.pdf
[3]	ZENG Y, CUI Y, LI J. Prevalence and predictors of antenatal depressive symptoms among Chinese women in their third trimester: A cross-sectional survey[J]. BMC Psychiatry, 2015, 15(9): 66-69. doi: 10.1186/s12888-015-0452-7
[4]	董青青, 李玉萍, 缪华章, 等. 孕产妇妊娠不同时期抑郁症状及其影响因素分析[J]. 中国生育健康杂志, 2017, 28(2): 106-109. doi: 10.3969/j.issn.1671-878X.2017.02.002
[5]	LEBEL C, WALTON M, LETOURNEAU N, et al. Prepartum and postpartum maternal depressive symptoms are related to children's brain structure in preschool[J]. Biol Psychiatry, 2016, 80(11): 859-868. doi: 10.1016/j.biopsych.2015.12.004
[6]	吴文源. 抑郁自评量表[M]//张作记. 行为医学量表手册. 北京: 中华医学电子音像出版社, 2005: 223-224.
[7]	刘贤臣, 唐茂芹. 匹慈堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, 29(2): 103-107.
[8]	肖水源. 《社会支持评定量表》的理论基础与研究应用[J]. 临床精神医学杂志, 1994, 4(2): 127-131. https://www.cnki.com.cn/Article/CJFDTOTAL-LCJS402.019.htm
[9]	林婉茹, 何丽芳, 宁芳芳, 等. 二胎孕妇抑郁状况及影响因素的研究[J]. 齐齐哈尔医学院学报, 2018, 39(21): 2531-2534. doi: 10.3969/j.issn.1002-1256.2018.21.022
[10]	何敏芝, 李益民, 汤阿毛, 等. 瘢痕子宫再次妊娠孕产妇及其配偶围生期心理状况研究[J]. 中国妇幼健康研究, 2018, 29(10): 1248-1251. doi: 10.3969/j.issn.1673-5293.2018.10.008
[11]	张轶岚, 胡文娟, 伯秋芳, 等. 二胎政策下高龄孕产妇分娩方案选择的影响因素及分娩知识知晓情况分析[J]. 中国妇幼健康研究, 2017, 28(7): 866-867, 886. doi: 10.3969/j.issn.1673-5293.2017.07.037
[12]	刘维琴, 蔡传兰, 崔时敏, 等. 妊娠期抑郁症状与睡眠质量的关联研究[J]. 中国妇幼保健, 2015, 30(23): 4002-4004. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201523032.htm
[13]	SEDOV I D, CAMERON E E, MADIGAN S, et al. Sleep quality during pregnancy: A meta-analysis[J]. Sleep Med Rev, 2018, 38(1): 168-176. http://smartsearch.nstl.gov.cn/paper_detail.html?id=530283c2caa60b271d0a8cfcd171beac
[14]	卢丽燕, 钟小燕. 高龄孕妇的心理健康状态调查及其危险因素分析[J]. 中国妇幼卫生杂志, 2017, 8(3): 58-60, 68. https://www.cnki.com.cn/Article/CJFDTOTAL-YZWS201703015.htm
[15]	刘秀萍, 宋锦平. 二胎孕妇产前抑郁发生现状及相关因素研究[J]. 中华现代护理杂志, 2016, 22(30): 4363-4367. doi: 10.3760/cma.j.issn.1674-2907.2016.30.017
[16]	杨靖, 王仙仙, 邱萌, 等. 二孩政策后二胎孕妇的产前焦虑调查及相关因素分析[J]. 中国民康医学, 2018, 30(9): 77-79. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMYX201809035.htm