胎儿异常引产妇女心理因素分析及干预研究

贺琰; 余晓燕; 余幼芬; 安静娜

doi:10.16766/j.cnki.issn.1674-4152.003251

胎儿异常引产妇女心理因素分析及干预研究

doi: 10.16766/j.cnki.issn.1674-4152.003251

1.
舟山市妇女儿童医院产科，浙江舟山 316000
2.
浙江大学医学院附属妇产科医院产科，浙江杭州 310000
3.
舟山市妇女儿童医院护理部

基金项目:

浙江省医药卫生科技计划项目 2020KY173

详细信息

通讯作者:
余幼芬，E-mail: youfenyu666@126.com

中图分类号: R719.3
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出版历程
- 收稿日期: 2023-05-26

Analysis of psychological factors and intervention of women with abnormal fetal induction of labor

HE Yan¹,
YU Xiaoyan²,
YU Youfen^{3
, ,},
AN Jingna³

1.
Department of Obstetrics, Zhoushan Women and Children' s Hospital, Zhoushan, Zhejiang 316000, China

摘要

摘要: 目的胎儿异常引产不仅对产妇的生理造成损害，也对心理造成极大的创伤。本研究旨在探讨胎儿异常引产导致孕产妇抑郁的影响因素，并研究对其进行心理干预的临床效果。方法利用便利抽样法，选取2019年10月—2022年10月舟山市妇女儿童医院收治的142例胎儿异常引产妇女作为研究对象，利用爱丁堡产后抑郁量表调查胎儿异常引产妇女的得分情况，分析导致引产后焦虑抑郁的因素，观察心理干预后的效果。结果胎儿异常引产妇女抑郁发生率为44.37%(63/142)，对其进行心理干预后，爱丁堡产后抑郁量表评分从干预前的(10.86±2.86)分降至(9.18±3.08)分，差异有统计学意义(P<0.05)。单因素分析发现不同文化水平、既往流产次数、社会支持得分的引产妇女爱丁堡产后抑郁量表评分比较差异有统计学意义(均P<0.05)。胎儿异常引产妇女平均社会支持得分为45.33分。Logistic多因素回归分析发现文化水平、既往流产次数、社会支持是引产后焦虑抑郁的主要影响因素。结论胎儿异常引产妇女的抑郁发生率较高，文化水平、既往流产次数、社会支持是引产后焦虑抑郁的影响因素，通过心理干预可有效降低胎儿异常引产妇女的焦虑和抑郁水平。
- 胎儿异常引产 /
- 心理因素分析 /
- 焦虑 /
- 抑郁 /
- 心理干预
Abstract: Objective Abnormal fetal induction of labor not only causes damage to the mother' s physiology, but also causes great psychological trauma. The purpose of this study is to explore the factors analysis of maternal depression and anxiety caused by abnormal fetal labor induction, and to study the clinical effect of psychological intervention. Methods Using convenience sampling method, 142 cases of women with abnormal fetal labor induction admitted to Zhoushan Women and Children's Hospital from October 2019 to October 2022 were selected as research objects. Edinburgh postpartum depression scale was used to investigate the scores of women with abnormal fetal labor induction, analyze the main factors leading to anxiety and depression after labor induction, and explore the clinical effect of psychological intervention. Results The incidence of depression in women with abnormal fetal induction was 44.37% (63/142). After psychological intervention, the score of Edinburgh postnatal depression scale decreased from (10.86±2.86) points before intervention to (9.18±3.08) points, and the difference was statistically significant (P<0.05). Univariate analysis showed that there were statistically significant differences in the scores of Edinburgh postnatal depression scale among women with different education levels, number of previous abortions and social support scores (all P<0.05). The average score of social support was 45.33 points. Logistic multivariate regression analysis showed that educational level, previous number of abortions and social support were the main influencing factors of anxiety and depression after induction of labor. Conclusion The incidence of depression and anxiety is higher in women with abnormal fetal labor induction. The educational level, the number of previous abortions and social support are the influencing factors of anxiety and depression after labor induction. Psychological intervention can effectively reduce the level of anxiety and depression in women with abnormal fetal labor induction.
- Fetal abnormal induction of labor /
- Analysis of psychological factors /
- Anxiety /
- Depression /
- Psychological intervention
利益冲突 无

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表 1 胎儿异常引产妇女焦虑抑郁单因素分析(x±s，分)

Table 1. Single factor analysis of anxiety and depression in women with abnormal fetal induction (x±s, points)

项目	类别	例数	EPDS	统计量	P值
年龄(岁)	23~<35	92	10.46±2.10	0.248^a	0.804
	35~42	50	10.37±1.99
孕周(周)	<17	56	9.38±2.07	0.863^b	0.389
	17~20	54	10.01±3.18
	>20	32	9.89±2.18
BMI	<18.5	34	10.15±3.01	0.031^b	0.973
	18.5~24.0	49	10.22±2.88
	>24.0	59	10.29±2.71
文化水平	高中及以下	22	9.27±1.98	5.350^b	0.006
	本科	76	10.89±3.10
	硕士及以上	44	11.76±2.97
既往流产次数(次)	0	65	9.36±1.99	6.201^b	0.003
	1	43	10.37±2.14
	≥2	34	10.86±2.46
社会支持得分(分)	≤45.33	67	10.94±2.22	4.788^a	<0.001
	>45.33	75	9.17±2.18
注：^a为t值，^b为F值。

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表 2 胎儿异常引产妇女焦虑抑郁多因素分析

Table 2. Multi-factor analysis of anxiety and depression in women with abnormal fetal induction

项目	B	SE	Wald χ²	P值	OR值	95% CI
文化水平
本科	-2.485	1.503	12.342	0.028	0.043	0.010~0.079
硕士及以上	-2.173	1.477	13.024	0.018	0.025	0.015~0.086
既往流产次数
1次	2.870	1.267	10.394	0.044	15.483	3.008~25.398
2次及以上	2.198	1.483	11.022	0.038	8.658	2.175~10.709
社会支持得分
>45.33分	3.110	1.388	18.104	0.036	0.528	0.241~0.899
注：文化水平以高中及以下为参照，既往流产次数以0次为参照，社会支持得分以≤45.33分为参照。

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