孕妇心理对妊娠结局的影响

Effect of mental health status of pregnant women on pregnant outcomes

目的了解孕妇心理状况和妊娠结局之间的关系,为孕期保健提供依据。方法应用症状自评量表(SCL-90)和自评抑郁量表(SDS)对243例妊娠中期孕妇进行调查,在其分娩时记录各产程时间和产时出血量,并对新生儿记录Apgar评分。结果243例孕妇的SCL-90总分均值为(25.16±20.58)分,其中躯体化、强迫、抑郁、焦虑、敌对、恐怖、偏执7个因子以及SCL阳性项目数得分显著高于常模;SCL-90评价指标和妊娠结局之间无相关性;SDS量表总均分高于我国女性常模;SDS单项分18项高于女性常模;抑郁组的产程、产后出血以及新生儿评分Apgar与对照组比较,差异有统计学意义(P<0.05)。结论妊娠中期孕妇心理健康可以影响到胎儿,导致新生儿Apgar评分改变,因此,应加强围生期保健工作,以提高妊娠质量,使妊娠和分娩顺利进行,以促进母子的身心健康。

Objective To examine the relation between mental health status of pregnant women and their pregnant outcomes. Methods Symptom Checklist 90 （SCL-90） and self-rating Depression Scale （SDS） assessments were administered to 243 pregnant women during their second pregnant trimester. Duration of each labor phase and postpartum hemorrhage of women and the Apgar of newborn were recorded during delivery. Results The mean general symptomatic index was 25.16± 20.58. The scores of somatization, obsessive-compulsion, depression, anxiety, hostility, phobic anxiety, paranoid ideation and the number of positive item were significantly higher than those of the Chinese female norm. No significant correlation was found between SCL-90 indexes and pregnant outcomes. The general mean score of SDS was higher than that of the norm. 18 SDS single scores were higher than those of the norm. The labor phase duration, postpartum hemorrhage and newborn＇s Apgar scores of depression group were significantly different from those of control group （P〈0. 05）. Conclusion The mental health status of pregnant women in second trimester may influence the fetal health, and can cause the changing of newborn＇s Apgar score. More effort for perinatal healty care should be made to improve the delivery quality and promote the maternal and child healty.