初产妇产前抑郁与分娩方式、产时并发症及胎儿结局的关系

Correlation of prenatal depression with delivery types,puerperal complications and fetal outcomes in primiparas

目的探讨初产妇产前抑郁与分娩方式、产时并发症及胎儿结局的关系。方法选取2019年3月1日-2019年9月30日在本院入院待产的初产妇为研究对象,入院时对研究对象进行爱丁堡抑郁量表评分,根据评分结果分为抑郁组和非抑郁组。采用二元logistic回归分析初产妇产前抑郁与分娩方式、产时并发症及胎儿结局的相关性。结果抑郁组191例与非抑郁组572例的剖宫产[25例(13.1%)vs 44例(7.7%),P=0.024]、胎盘早剥[3例(1.6%)vs 0例(0),P=0.016]、产后出血[19例(9.9%)vs 27例(4.72%),P=0.009]、新生儿转儿科[9例(4.7%)vs 8例(1.4%),P=0.016]、早产[8例(4.2%)vs 7例(1.2%),P=0.024]、胎儿窘迫[28例(14.7%)vs 53例(9.3%),P=0.036]等指标,组间差异有统计学意义(P均<0.05);在产钳助产、产时感染、新生儿体质量、身长、胸围、新生儿1 min Apgar评分、新生儿5 min Apgar评分等方面,组间差异无统计学意义(P>0.05)。二元logistic回归分析结果显示,初产妇分娩方式、产时并发症及胎儿不良结局与产前抑郁密切相关(OR>1,P均<0.05)。结论患有产前抑郁的初产妇,其非自然分娩、产时并发症及胎儿不良结局风险增加,应及早对妊娠期女性进行心理筛查和心理干预,以保障分娩的安全。

Objective To explore the relationship between prenatal depression and delivery types,puerperal complications and fetal outcomes in primiparas.Methods The primiparas admitted to our hospital for delivery from March 1,2019 to September 30,2019 were selected as the research subjects,and they were investigated by the Edinburgh Depression Scale on admission and divided into depression group(191 cases)and non-depression group(572 cases).Binary logistic regression was used to analyze the correlation of prenatal depression with delivery methods,puerperal complications,and fetal outcomes.Results There were 191 cases in the depression group and 572 cases in the non-depression group.The two groups had significant differences in rate of cesarean section(25 cases[13.1%]vs 44 cases[7.7%],P=0.024),placental abruption(3 cases[1.6%]vs 0 case[0],P=0.016),postpartum hemorrhage(19 cases[9.9%]vs 27 cases[4.72%],P=0.009),neonatal transfer to pediatrics(9 cases[4.7%]vs 8 cases[1.4%],P=0.016),premature delivery(8 cases[4.2%]vs 7 cases[1.2%],P=0.024),fetal distress(28 cases[14.7%]vs 53 cases[9.3%],P=0.036),etc;There was no significant difference in forceps delivery,postpartum infections,neonatal weight,length,bust,1-minute Apgar score of newborn,5-minute Apgar score of newborn(all P>0.05).The results of binary logistic regression analysis showed that the delivery types,puerperal complication and adverse fetal outcomes were closely related to prenatal depression in the primiparas(all P<0.05,OR>1).Conclusion Prenatal depression in primiparous women increases the risk of unnatural delivery,puerperal complications and adverse fetal outcomes.Psychological screening and intervention should be carried out to pregnant women as early as possible to ensure the maternal and neonatal safety.