妊娠中晚期心理健康现状及其影响因素的研究

赵金龙; 陆慧; 肖凌燕; 谭洁

doi:10.16766/j.cnki.issn.1674-4152.003467

妊娠中晚期心理健康现状及其影响因素的研究

doi: 10.16766/j.cnki.issn.1674-4152.003467

嘉兴市妇幼保健院妇女保健科，浙江嘉兴 314000

基金项目:

浙江省医药卫生科技计划项目 2023KY1223

详细信息

通讯作者:
赵金龙，E-mail：18906736605@163.com

中图分类号: R714.1 R749.4
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- 被引次数: 0
出版历程
- 收稿日期: 2023-11-25
- 网络出版日期: 2024-05-29

Study on the status and influencing factors of mental health in the second and third trimesters of pregnancy

Women' s Health Department, Jiaxing Maternal and Child Health Hospital, Jiaxing, Zhejiang 314000, China

摘要

摘要: 目的分析妊娠中晚期孕妇抑郁状态，探讨其影响因素，为早期识别妊娠中晚期抑郁高危人群提供参考依据。方法选择2022年1月—2023年9月于嘉兴市妇幼保健院产科常规产检的妊娠中晚期孕妇作为研究对象，运用一般资料调查表、爱丁堡抑郁量表(EPDS-10)进行调查分析，并采用logistic回归分析研究妊娠期抑郁状态的影响因素。结果妊娠中期孕妇抑郁症发生率(14.93%，268/1 795)高于妊娠晚期(9.77%，55/563)，差异有统计学意义(P＜0.05)，妊娠中期与妊娠晚期比较，轻度抑郁及中重度抑郁构成比差异无统计学意义(P＞0.05)；妊娠中期抑郁症孕妇年龄≥35岁、大专学历、有不良孕产史、未婚或离异、计划外妊娠比例高于非抑郁症的孕妇，差异均有统计学意义(P＜0.001)，其中大专学历、有不良孕产史、未婚或离异、计划外妊娠均是妊娠中期孕妇抑郁的独立危险因素(P＜0.05)，妊娠中期抑郁症与非抑郁症孕妇常住地、分娩史、家庭月收入差异均无统计学意义(P＞0.05)；妊娠晚期抑郁症孕妇年龄≥35岁、大专学历、无分娩史、有不良孕产史、未婚或离异、计划外妊娠比例高于非抑郁症的孕妇，差异均有统计学意义(P＜0.05)，有不良孕产史、计划外妊娠是妊娠晚期孕妇抑郁的独立危险因素(P＜0.05)，妊娠晚期抑郁症与非抑郁症孕妇常住地、家庭月收入差异均无统计学意义(P＞0.05)。结论妊娠中期孕妇抑郁症发生率高于妊娠晚期，大专学历、有不良孕产史、未婚或离异及计划外妊娠会增加妊娠中晚期抑郁症发生风险。
- 妊娠期 /
- 抑郁症 /
- 影响因素 /
- 现状
Abstract: Objective To analyze the depressive state of pregnant women in the second and third trimesters of pregnancy and to explore the influencing factors. This will provide a reference for early identification of high-risk groups for depression during these stages of pregnancy. Methods From January 2022 to September 2023, we selected pregnant women in the middle and third trimester of obstetric pregnancy who anderwent routine prenatal care at Jiaxing Maternal and Child Health Hospital as research subjects. We used a general data questionnaire and the Edinburgh depression scale (EPDS-10) to investigate and analyze the factors influencing depressive states during pregnancy using logistic regression. Results The second trimester had a higher incidence of depression (14.93%, 268/1 795) compared to the third trimester (9.77%, 55/563), the difference was statistically significant (P < 0.05). However, there was no statistically significant difference in the proportion of mild depression and moderate to severe depression between the second and third trimesters (P>0.05). The proportion of pregnant women with depression in the second trimester who were aged 35 or older, had a college education, had an adverse pregnancy history, were unmarried or divorced, or had an unplanned pregnancy was significantly higher than that of non-depressed pregnant women (P < 0.001). College education, adverse pregnancy history, unmarried or divorced status and unplanned pregnancy were identified as the independent risk factors for depression in the second trimester of pregnancy (P < 0.05). There was no statistically significant difference in the second trimester of depression between pregnant women with the regular residence, delivery history, and monthly family income and those who were not depressed (P>0.05). The proportion of pregnant women with depression in the third trimester who were aged ≥35 or older had a college education, no history of childbirth, adverse pregnancy history, unmarried or divorced, or had an unplanned pregnancy was higher than that of non-depressed pregnant women, the differences were statistically significant (P < 0.05). In the third trimester, pregnant women with adverse pregnancy history and unplanned pregnancy were found to be at a higher risk of depression (P < 0.05). There was no significant difference in the regular residence and monthly family income of pregnant women with depression in the third trimester and those without depression (P>0.05). Conclusion Depression is more common in pregnant women during the second trimester than in the third. Risk factors for depression during the second trimester include having a college education, a history of adverse pregnancy, being unmarried or divorced, and having an unplanned pregnancy.
- Pregnancy period /
- Depression /
- Influencing factors /
- Status

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表 1 妊娠中晚期孕妇抑郁症发病情况比较[例(%)]

Table 1. The incidence of depression in pregnant women in the middle and late pregnancy[cases(%)]

组别	例数	轻度抑郁	中重度抑郁	抑郁症总发生
妊娠中期	1 795	173(64.55)	95(35.45)	268(14.93)
妊娠晚期	563	34(61.82)	21(38.18)	55(9.77)
χ²值		0.148		9.657
P值		0.758		0.002

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表 2 妊娠中期孕妇抑郁情绪单因素分析[例(%)]

Table 2. Univariate analysis of depressive mood in pregnant women during second trimester[cases(%)]

项目	例数	抑郁症 (n=268)	非抑郁症 (n=1 527)	χ²值	P值
年龄
≥35岁	160	48(17.91)	112(7.33)	31.407	＜0.001
＜35岁	1 635	220(82.09)	1 415(92.67)
文化程度
初中及以下	336	55(20.52)	281(18.40)	17.339	0.001
高中及中专	222	37(13.81)	185(12.12)
大专	550	103(38.43)	447(29.27)
本科及以上	687	73(27.24)	614(40.21)
常住地
城镇	1 014	140(52.24)	874(57.24)	2.317	0.142
农村	781	128(47.76)	653(42.76)
分娩史
有	629	102(38.06)	527(34.51)	1.261	0.267
无	1 166	166(61.94)	1 000(65.49)
不良孕产史
有	95	35(13.06)	60(3.93)	37.918	＜0.001
无	1 700	233(86.94)	1 467(96.07)
家庭月收入
好	111	18(6.72)	93(6.09)	0.195	0.907
中	1 627	241(89.92)	1 386(90.77)
差	57	9(3.36)	48(3.14)
婚姻状况
初婚	1 542	203(75.75)	1 339(87.69)	32.256	＜0.001
再婚	146	31(11.57)	115(7.53)
未婚或离异	107	34(12.68)	73(4.78)
计划外妊娠
是	464	106(39.55)	358(23.44)	30.860	＜0.001
否	1 331	162(60.45)	1 169(76.56)
注：家庭月收入＞10 000元为好，5 000~10 000元为中，＜5 000元为差。

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表 3 妊娠中期孕妇抑郁情绪多因素分析

Table 3. Multivariate analysis of depressive mood in pregnant women during second trimester

变量	B	SE	Waldχ²	P值	OR值	95% CI
年龄≥35岁	0.328	0.307	1.142	0.285	1.388	0.761~2.531
文化程度
高中及中专	0.357	0.307	1.354	0.245	1.429	0.783~2.609
大专	0.633	0.306	4.276	0.039	1.883	1.034~3.432
本科及以上	0.075	0.330	0.052	0.820	1.078	0.565~2.057
不良孕产史	1.387	0.343	16.389	＜0.001	4.003	2.045~7.835
婚姻状况
再婚	0.545	0.307	3.155	0.076	1.724	0.945~3.146
未婚或离异	1.132	0.332	11.646	0.001	3.102	1.619~5.942
计划外妊娠	0.848	0.390	4.719	0.030	2.334	1.086~5.016
注：文化程度以初中及以下为参照, 婚姻状况以初婚为参照。

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表 4 妊娠晚期孕妇抑郁情绪单因素分析[例(%)]

Table 4. Univariate analysis of depressive mood in pregnant women in the third trimester[cases(%)]

项目	例数	抑郁症 (n=55)	非抑郁症 (n=508)	χ²值	P值
年龄
≥35岁	62	11(20.00)	51(10.03)	5.024	0.038
＜35岁	501	44(80.00)	457(89.97)
文化程度
初中及以下	75	5(9.09)	70(13.78)	11.357	0.014
高中及中专	80	8(14.55)	72(14.17)
大专	152	25(45.45)	127(25.00)
本科及以上	256	17(30.91)	239(47.05)
常住地
城镇	218	23(41.82)	195(38.39)	0.246	0.663
农村	345	32(58.18)	313(61.61)
分娩史
有	208	9(16.36)	199(39.17)	11.084	0.001
无	355	46(83.64)	309(60.83)
不良孕产史
有	48	15(27.27)	33(6.50)	27.469	＜0.001
无	515	40(72.73)	475(93.50)
家庭月收入
好	36	4(7.27)	32(6.30)	0.642	0.726
中	489	46(83.64)	443(87.20)
差	38	5(9.09)	33(6.50)
婚姻状况
初婚	515	46(83.64)	469(92.32)	9.824	0.037
再婚	37	5(9.09)	32(6.30)
未婚或离异	11	4(7.27)	7(1.38)
计划外妊娠
是	120	26(47.27)	94(18.50)	24.490	＜0.001
否	443	29(52.73)	414(81.50)

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表 5 妊娠晚期孕妇抑郁情绪多因素分析

Table 5. Multivariate analysis of depressive mood in pregnant women in the third trimester

变量	B	SE	Waldχ²	P值	OR值	95% CI
年龄≥35岁	0.439	0.384	1.312	0.252	1.552	0.732~3.292
文化程度
高中及中专	0.049	0.326	0.022	0.881	1.050	0.554~1.989
大专	0.125	0.329	0.144	0.704	1.133	0.595~2.158
本科及以上	0.184	0.317	0.336	0.562	1.202	0.645~2.239
无分娩史	0.227	0.337	0.455	0.500	1.255	0.649~2.427
有不良孕产史	1.412	0.352	16.050	＜0.001	4.104	2.057~8.190
婚姻状况
再婚	0.118	0.339	0.121	0.728	1.125	0.579~2.188
未婚或离异	0.553	0.437	1.602	0.206	1.739	0.738~4.096
计划外妊娠	0.848	0.398	4.543	0.033	2.334	1.071~5.088
注：文化程度以初中及以下为参照，婚姻状况以初婚为参照。

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