孕妇产前焦虑状况及其对分娩结局的影响

Prenatal anxiety and its influence on delivery outcome

目的:调查孕妇产前焦虑状况的相关因素,观察产前焦虑对分娩方式、产时出血的影响,分析产前焦虑与分娩结局之间的关系。方法:抽取符合调查要求的住院待产孕妇300例为研究对象,采用自编孕妇一般资料问卷、焦虑状态-特质问卷(STAI)、妊娠压力量表、社会支持评定量表(SSRS)对孕妇产前进行问卷调查,分娩后追踪其分娩结局资料。结果:孕妇产前状态焦虑评分为43.58±10.79,高于常模(P<0.01)。经多元线性回归分析,妊娠压力因子2、与婆婆的关系、流产次数、产前健康状况、孕妇学校听课次数、对分娩的心理准备、与母亲的关系、与丈夫的关系、妊娠压力因子3、压力因子1与孕妇产前焦虑相关。无指征剖宫产组与自然分娩组两者焦虑评分比较,差异有统计学意义(P<0.01)。无指征剖宫产组中,焦虑与非焦虑2组产时出血量比较差异有统计学意义(P<0.01)。结论:孕妇心理压力、与婆婆的关系、流产次数、产前健康状况、孕妇学校听课次数、对分娩的心理准备、与母亲的关系、与丈夫的关系是影响孕妇产前状态焦虑的重要因素。孕妇产前焦虑可导致无指征剖宫产及剖宫产产时出血的增加。

Objective To investigate the factors related to prenatal anxiety,to observe the effect of prenatal anxiety on the mode of delivery,intrapartum hemorrhage,and to determine the correlation between prenatal anxiety and delivery outcome.Methods A total of 300 pregnant women were randomly enrolled from 3 hospitals of Changsha,China.The instruments of this survey were self-designed general information questionnaire,state-trait anxiety inventory （STAI）,pregnancy pressure scale,and social support rating scale （SSRS）.The delivery outcome was observed.Results The STAI showed that the state anxiety score of the pregnant women was 43.58±10.79,which was significantly higher than that of usual models （P〈0.01）.Multiple linear regression analysis showed that those factors,such as the item 2 of pregnancy pressure,relationship with mother-in-law,number of abortions,prenatal health condition,times of attending classes for pregnant women,psychological preparation for childbirth,relationship with mother,relationship with husband,item 3 and item 1 of pregnancy pressure,were all related to prenatal anxiety.The anxiety level between the non-indicative cesarean section group and the normal labor group had statistical difference （P〈0.01）.Intrapartum hemorrhage of cesarean section in the anxiety group had significant difference compared with the non-anxiety group （P〈0.01）.Conclusion Some factors have contributed to the anxiety level of the pregnant,such as psychological stress,relationship with mother-in-law,number of abortions,prenatal health conditions,times of attending classes for pregnant women,psychological preparation for childbirth,relationship with mother,and relationship with husband.Prenatal anxiety may lead to increased the rate of non-indicative cesarean section and intrapartum hemorrhage during the cesarean section.