842例高龄孕产妇心理健康影响因素及妊娠结局探讨
|
摘要
目的探讨高龄孕产妇焦虑、抑郁的发生情况、影响因素及其与不良妊娠结局关系,为高龄孕产妇的心理调节提供理论依据。方法选取2016年1月至2017年1月在东莞市第五人民医院就诊的842例高龄孕产妇(年龄>35岁)行焦虑自评量表(self-rating depression scale,SDS)及抑郁自评量表(self-rating anxiety scale,SAS)问卷调查,并根据结果分为不良组(312例)及健康组(530例),Logistics分析高龄孕产妇不良心理影响因素,比较两组不良妊娠结局发生情况。结果 842例高龄孕产妇SDS评分:正常624例(74.11%)、轻度焦虑106例(12.59%)、中度焦虑68例(8.08%)、重度焦虑44例(5.22%);SAS评分:正常684例(81.23%)、轻度抑郁84例(9.98%)、中度抑郁57例(6.77%)、重度抑郁17例(2.02%);经logistcs多因素分析,有流产史、家庭人均月收入<2 000元、与家庭成员关系不好、男孩期望值高均为不良心理应激的独立危险因素,自然受孕为不良心理应激的保护性因素,差异均有统计学意义(P<0.05);不良组妊娠期高血压疾病(6.73%)、妊娠期糖尿病(5.77%)、早产(8.65%)、低体重儿(11.22%)及胎儿窘迫(9.29%)的发生率均高于健康组(2.26%、2.08%、3.21%、3.96%、4.34%),差异有统计学意义(P<0.05)。结论高龄孕产妇不良心理应激危险因素的研究有利于更好地对其进行心理疏导,减少不良妊娠结局的发生。
Objective To explore the relationship between the incidence of anxiety and depression, the influencing factors and the adverse pregnancy outcomes in clderly materal, and to provide a theoretical basis for the psychological adjustment of clderly materal. Methods 842 elderly pregnant women(age>35) were investigated by self rating anxiety scale(SAS) and self rating depression scale(SDS). According to the results, the patients were divided into the adverse group(312 cases) and the healthy group(530 cases). Logistics analysis of the adverse psychological factors of the maternal pregnant women and the adverse pregnancy outcomes of the two groups were compared. Results SDS scores of 842 pregnant women: 624(74.11 %), 106(12.59 %) with mild anxiety, 68(8.08 %) with moderate anxiety, and 44(5.22 %) with severe anxiety; SAS score: 684 cases(81.23 %), 84 cases(9.98 %) with mild depression, 57 cases(6.77 %) with moderate depression, and 17 cases(2.02 %) with severe depression; After logistics multivariate analysis, there was a history of abortion, family income < 2 000 yuan, poor relationship with family members, and high expectations of boys were independent risk factors for adverse psychological stress. Natural pregnancy was a protective factor for adverse psychological stress. All were statistically significant(P<0.05); the incidence of gestational hypertension(6.73 %), gestational diabetes(5.77 %), premature delivery(8.65 %), low birth weight(11.22 %), and fetal distress(9.29 %) were higher in the adverse group than in the healthy group(P<0.05).Conclusion The study of risk factors for adverse psychological stress in pregnant women is beneficial to better psychological counseling and reduce the occurrence of adverse pregnancy outcomes.
Objective To explore the relationship between the incidence of anxiety and depression, the influencing factors and the adverse pregnancy outcomes in clderly materal, and to provide a theoretical basis for the psychological adjustment of clderly materal. Methods 842 elderly pregnant women(age>35) were investigated by self rating anxiety scale(SAS) and self rating depression scale(SDS). According to the results, the patients were divided into the adverse group(312 cases) and the healthy group(530 cases). Logistics analysis of the adverse psychological factors of the maternal pregnant women and the adverse pregnancy outcomes of the two groups were compared. Results SDS scores of 842 pregnant women: 624(74.11 %), 106(12.59 %) with mild anxiety, 68(8.08 %) with moderate anxiety, and 44(5.22 %) with severe anxiety; SAS score: 684 cases(81.23 %), 84 cases(9.98 %) with mild depression, 57 cases(6.77 %) with moderate depression, and 17 cases(2.02 %) with severe depression; After logistics multivariate analysis, there was a history of abortion, family income < 2 000 yuan, poor relationship with family members, and high expectations of boys were independent risk factors for adverse psychological stress. Natural pregnancy was a protective factor for adverse psychological stress. All were statistically significant(P<0.05); the incidence of gestational hypertension(6.73 %), gestational diabetes(5.77 %), premature delivery(8.65 %), low birth weight(11.22 %), and fetal distress(9.29 %) were higher in the adverse group than in the healthy group(P<0.05).Conclusion The study of risk factors for adverse psychological stress in pregnant women is beneficial to better psychological counseling and reduce the occurrence of adverse pregnancy outcomes.
引文
[1] 仝玉丽.围生期综合护理干预对高龄孕产妇及新生儿的影响 [J].齐鲁护理杂志,2017,23(8):86-88.
[2] 林美苑,余佳佳.苍南县599例妊娠期妇女心理状态症状自评量表调查分析 [J].中国妇幼保健,2015,30(31):5452-5454.
[3] 杨玮莉,黄文文.高龄产妇180例妊娠结局分析 [J].基层医学论坛,2014,18(4):454-455.
[4] MAKARA-STUDZINSKA M,MORYLOWSKA-TOPOLSKA J,SYGIT K,et al.Socio-demographical and psychosocial determinants of anxiety symptoms in a population of pregnant women in the regions of central and eastern Poland [J].Annals of Agricultural and Environmental Medicine,2013,20 (1):195-202.
[5] AASHEIM V,WALDENSTR M U,HJELMSTEDT A,et al.Associations between advanced maternal age and psychological distress in primiparous women,from early pregnancy to 18 months postpartum [J].BJOG :an International Journal of Obstetrics and Gynaecology,2012,119 (9):1108-1116.
[6] KENNY L C,LAVENDER T,MCNAMEE R,et al.Advanced maternal age and adverse pregnancy outcome:evidence from a large contemporary cohort [J].PLOS One,2013,8 (2):e 56583.
[7] 周静.高龄妊娠孕产妇的心理护理 [J].中国实用神经疾病杂志,2012,15(7):81-82.
[8] 方莉,吴丽萍,王秋明.北京市某三甲医院高龄初产妇孕期焦虑、抑郁状况的调查 [J].中华现代护理杂志,2011,17(1):30-32.
[9] 陶秀英,张秀平,穆傲霜.高龄初产妇的心理特征及护理 [J].中华全科医学,2009,7(3):316.
[10] 邝云航,赵莉,张健平.心理干预对围产期高龄孕产妇心理健康及应对方式的影响 [J].临床心身疾病杂志,2009,15(4):340-341.
[11] 周玉润,叶傲霜,周景敏,等.高龄孕产妇出生儿体格生长及神经心理发育研究 [J].江西医药,2008,43(5):445-447.
[12] 李利平.高龄初产妇住院期的心理护理 [J].中华现代护理杂志,2008,14(28):3016-3017.
[13] 林红艳.152例高校孕产妇情况调查与分析 [J].中国妇幼保健,2006,21(5):633.
[14] 白希敏.高龄初产分娩前后的心理特征及其护理 [J].基层医学论坛,2006,10(24):1105.
[15] 陈燕珊,郭实贤.高龄初产妇分娩前后的心理特征及护理对策 [J].实用医技杂志,2006,13(20):3678.
[16] 曹秋云.高龄孕产妇的心理健康问题及处理 [J].中国实用妇科与产科杂志,2006,22(10):729-732.
[2] 林美苑,余佳佳.苍南县599例妊娠期妇女心理状态症状自评量表调查分析 [J].中国妇幼保健,2015,30(31):5452-5454.
[3] 杨玮莉,黄文文.高龄产妇180例妊娠结局分析 [J].基层医学论坛,2014,18(4):454-455.
[4] MAKARA-STUDZINSKA M,MORYLOWSKA-TOPOLSKA J,SYGIT K,et al.Socio-demographical and psychosocial determinants of anxiety symptoms in a population of pregnant women in the regions of central and eastern Poland [J].Annals of Agricultural and Environmental Medicine,2013,20 (1):195-202.
[5] AASHEIM V,WALDENSTR M U,HJELMSTEDT A,et al.Associations between advanced maternal age and psychological distress in primiparous women,from early pregnancy to 18 months postpartum [J].BJOG :an International Journal of Obstetrics and Gynaecology,2012,119 (9):1108-1116.
[6] KENNY L C,LAVENDER T,MCNAMEE R,et al.Advanced maternal age and adverse pregnancy outcome:evidence from a large contemporary cohort [J].PLOS One,2013,8 (2):e 56583.
[7] 周静.高龄妊娠孕产妇的心理护理 [J].中国实用神经疾病杂志,2012,15(7):81-82.
[8] 方莉,吴丽萍,王秋明.北京市某三甲医院高龄初产妇孕期焦虑、抑郁状况的调查 [J].中华现代护理杂志,2011,17(1):30-32.
[9] 陶秀英,张秀平,穆傲霜.高龄初产妇的心理特征及护理 [J].中华全科医学,2009,7(3):316.
[10] 邝云航,赵莉,张健平.心理干预对围产期高龄孕产妇心理健康及应对方式的影响 [J].临床心身疾病杂志,2009,15(4):340-341.
[11] 周玉润,叶傲霜,周景敏,等.高龄孕产妇出生儿体格生长及神经心理发育研究 [J].江西医药,2008,43(5):445-447.
[12] 李利平.高龄初产妇住院期的心理护理 [J].中华现代护理杂志,2008,14(28):3016-3017.
[13] 林红艳.152例高校孕产妇情况调查与分析 [J].中国妇幼保健,2006,21(5):633.
[14] 白希敏.高龄初产分娩前后的心理特征及其护理 [J].基层医学论坛,2006,10(24):1105.
[15] 陈燕珊,郭实贤.高龄初产妇分娩前后的心理特征及护理对策 [J].实用医技杂志,2006,13(20):3678.
[16] 曹秋云.高龄孕产妇的心理健康问题及处理 [J].中国实用妇科与产科杂志,2006,22(10):729-732.