长沙地区正常初产妇妊娠晚期抑郁心境的相关心理社会因素与剖宫产分娩方式的初步研究

Relationship Between Socialdemological Factors,Mental Stress and Dysthymia,Cesarean Section in Normal City Primipara

目的:探讨城镇正常初产妇妊娠晚期抑郁心境的心理社会因素及其与剖宫产分娩方式的关系。方法:采用流调用抑郁自评量表(CES-D)、孕妇社会人口学资料及心理应激因素自制评估表对200例长沙地区正常初产妇进行调查,产后对其分娩方式进行追踪调查。结果:200例城镇正常初产妇中妊娠晚期有抑郁心境者56例(28.0%)。年龄、受教育程度、家庭月均收入、参加孕妇学校情况、亲戚朋友分娩情况、对分娩的心理准备、与配偶关系、对胎儿健康的担心是产生抑郁心境的主要影响因素(P<0.05);孕妇的受教育程度、家庭月均收入、参加孕妇学校情况、对分娩的心理准备、对此次分娩的估计、自觉胎儿最安全的分娩方式、对分娩医院的信任,是剖宫产分娩方式的主要影响因素(P<0.05)。孕妇有抑郁心境者剖宫产率为78.6%,与正常心境剖宫产率63.2%相比差异有显著性(P<0.05)。结论:社会人口学因素及妊娠晚期心理应激是正常初产妇妊娠晚期抑郁心境及选择剖宫产分娩方式的主要影响因素。

Objective： To investigate socialdemological factors, mental stress and dysthymia and their relationship with Cesarean section in normal city primipara. Methods： In a prospective observational study, 200 normal city primipara were followed up longitudinally from 36 pregnancy weeks to labor. Their socialdemological factors were recorded, the level of mental stress and dysthymia were measured in late pregnancy by the self-made pregnanced women＇s questionaires and CES-D, mode of delivery was also recorded. Results： The occurrence rate of dysthymia among normal city pregnanced women was 28%. Age, educational level, family＇s mensal income, attendance of maternity school, friends and relatives with unfavorable delivery, mental preparation for delivery, relationship with husband and uneasiness about newborns＇ health were related significantly to the occurrence rate of dysthymia （P〈0.05）. Educational level, family＇s mensal income, attendance of maternity school, mental preparation for labor, estimation of this labor, consideration of the safest mode of delivery and credit to chosen hospital were all related significantly to Cesarean Section（P〈0.05 ）. The rate of cesarean section in dysthymia women was 78.6%, significantly higher than in normal pregnanced women （P〈0.05）. Conclusion： Socialdemologieal factors, mental stress are mainly influencing factors that affect dysthymia and cesarean section chosen in normal city primipara.