体外受精-胚胎移植妇女的焦虑、抑郁情绪

Anxiety and depression in women with in-vitro fertilization and embryo transfer treatment

目的:了解体外受精-胚胎移植(IVF-ET)妇女的焦虑、抑郁情绪及相关因素。方法:2009年4月-2010年3月,在湖南省妇幼保健院生殖中心选取来自全国各地符合本研究筛选标准的妇女连续入组,共入组IVF-ET妇女538例,采取现场询问的方式,在胚胎移植术后2小时内进行问卷调查,内容包括社会人口学特征、生育情况、治疗情况、社会心理因素及情绪症状的评定。结果:焦虑评分(39.6±3.1)分,焦虑症状检出率38.5%;抑郁评分(35.8±4.5)分,抑郁症状检出率12.3%。居住在城市(OR=1.66)、不孕年限长(OR=1.34)、夫妻交流少(OR=2.25)、积极应对评分低(OR=4.30)、生理健康(OR=3.24)评分低、心理健康(OR=5.36)评分低的IVF-ET妇女焦虑倾向危险比高;既往治疗费用多(OR=3.02),取卵个数少(OR=2.24)及性生活(OR=1.13)、积极应对(OR=6.08)评分低,应激性生活事件评分高(OR=1.83)的IVF-ET妇女抑郁倾向危险比高。结论:体外受精-胚胎移植妇女存在不同程度的焦虑、抑郁情绪,社会心理变量是其主要相关因素。

Objective： To explore the prevalence of anxiety and depression and the related factors in the women with in-vitro fertilization and embryo transfer （1VF-ET） treatment. Methods： A consecutive sample of 538 women with IVF-ET were recruited and assessed with the self-made questionnaire, version 2 of the SF-36 health survey （SF-36 v2）, Olson Enrich Marital Inventory （ENRICH）, Life Event Scale （LES）, Social Support Rating Scale （SSRS）, Trait Coping Style Questionnaire （TCSQ）, Self-Rating Anxiety Scale （SAS）, and Self-Rating Depression Scale （SDS） within 2 hours after IVF-ET. Results： The mean score of SAS was （39. 6 ± 3.1）, and the rate of anxiety symptoms was 38. 5%. The mean score of SDS was （35.8 ±4. 5）, and the rate of depression symptoms was 12. 3%. The women with IVF-ET treatment who lived in city （ OR = 1.66）, and had longer history of infertility （OR = 1.34）, less couples communication （OR = 2. 25）, lower positive coping （OR = 4. 30）, lower SF-36＇s physiological （OR = 3.24） and psychological （OR = 5.36） function scores, had higher risk of anxiety. Those who had higher expenditure of previous treatment （ OR = 3.02）, less number of the selected eggs （ OR = 2. 24）, lower sex life （OR = 1.13） and positive coping scores （OR =6. 08）, and more life events （OR = 1.83）, had higher risk of depression. Conclusion： It suggests that the women with initro fertilization and embryo transfer treatment show different levels of anxiety and depression syndromes. Social psychological variables may be the main related factors.