上海市不同妊娠时期孕妇的焦虑抑郁症状调查

An investigation of anxiety and depression disorders among pregnant women in different trimesters in Shanghai

目的了解不同孕期焦虑抑郁症状的发生情况，为开展有效的孕产期心理保健提供依据。方法采用医院用焦虑抑郁量表（HAD）对妊娠早期、中期、晚期3个不同妊娠时期的463名孕妇进行问卷调查。结果①妊娠早期、中期、晚期焦虑症状发生率分别为10．7％、8．1％、11．5％，抑郁症状发生率分男q为11．3％、6．8％、9．7％，妊娠早期和晚期焦虑抑郁症状发生率均高于妊娠中期（焦虑：Х^2=11．09，P=0．001;Х^2=10．15，P=0．001；抑郁：Х^2=11．22，P=0．001；Х^2=9．15，P=0．021）。外来孕妇总的焦虑抑郁症状发生率高于本地孕妇（Х^2=8．77，P=0．003；Х^2=10．24，P=0．001）；②Logistic回归分析显示孕期焦虑症状的危险因素为经济问题、害怕流产、婆媳关系紧张、夫妻关系紧张、担忧产后乳汁不足；孕期抑郁症状的危险因素为经济问题、性格内向、近2周胎儿检查结果异常。结论关注孕妇的心理状况，尤其是外来孕妇等重点人群，为其提供良好的社会和医学支持，预防孕期心理障碍的发生。

Objectives To investigate prevalence rates of anxiety and depression disorders among pregnant women in different trimesters, so as to provide basis for conducting effective maternal psychological health care. Methods 463 pregnant women in the first, the second and the third trimesters of pregnancy were investigated using Hospital Anxiety and Depression Scale （HAD） and self-designed questionnaire. Results ①The prevalence rates of anxiety disorder in three trimesters of pregnancy were 10.7%, 8.1% and 11.5% respectively, and the prevalence rates of depression disorder were 11.3%, 6.8% and 9.7% respectively. The prevalence rates of anxiety and depression in the first and the third trimesters of pregnancy were both higher than those in the second trimester of pregnancy（ for anxiety：Х^2 = 11.09, P =0.001 ;Х^2=10.5 ;0.001;Х^2 =10.15, P=0.001; for depression：Х^2 =11.22, P=0.001;Х^2 =9.15, P =0.021 ）.The overall prevalence rates of anxiety and depression among floating pregnant women were higher than those among permanent pregnant women （Х^2 = 8.77, P = 0. 003 ;Х^2 = 10.24, P = 0. 001 ） ; ②Logic regression analysis showed that major related risk factors of anxiety disorder of women during pregnancy were economic problems, being afraid of abortion, bad relationships with mother-in-law and husband, worrying about lack of breast milk after delivery, while those of depression were economic problems, introverted personality, and abnormal fetal examination results in recent 2 weeks. Conclusions It is necessary to pay more attention to pregnant women, especially to those floating pregnant women, provide them effective medical and social psychological supports, so as to prevent development of emotional disorders.