孕妇产前焦虑对分娩结局影响的临床研究及干预对策

Clinical study on influence of prenatal anxiety of the pregnancy on delivery outcome

目的 探讨孕妇产前焦虑对分娩结局的影响,并提出有效的干预对策.方法随机选取我院2012年1月~2013年6月住院待产孕妇260例为研究对象,采用焦虑状态-特质问卷（STAI）、自行设计的一般情况调查表、妊娠压力量表等对孕妇产前焦虑情况及一般情况进行调查,并跟踪至分娩后,观察不同焦虑状况孕妇分娩结局.结果 状态焦虑高于正常上限值40分37例,占14.23%,特质焦虑高于正常上限2例,占0.77%.焦虑状态的37例产妇中剖宫产31例,剖宫产率为83.78%,产时出血量为（245.5±35.6）mL,明显高于正常状态产妇,两组比较差异具有统计学意义（P〈0.05）.两组各产程及总产程时间比较差异无统计学意义（P＞0.05）.正常状态产妇1 min新生儿Apgar评分明显高于焦虑组,胎儿宫内窘迫、新生儿窒息的发生率分别为10.81%、10.81%,分别高于正常组,两组比较差异具有统计学意义（P＞0.05）.结论 孕妇产前焦虑状态对分娩结局的影响呈正相关,针对孕妇产前焦虑发生的原因采取针对性的干预,以提高分娩结局.

Objective To study the influence of prenatal anxiety of the pregnancy on delivery outcome. Methods A to- tal of 260 expectant mothers in our hospital from January 2012 to June 2013 were selected randomly as the research objects. And the prenatal anxiety and general conditions of the pregnancy were investigated until after childbirth by using State Trait Anxiety Inventory, general conditions chart and pregnancy stress scale. And the influence of different anxiety conditions on delivery outcome were observed. Results There were 37 cases with anxiety 4 scores higher than the upper limit of normal, accounted for 14.23%. There were 2 cases with trait anxiety higher than the upper limit of normal, accounted for 0.77%. There were 31 cases with cesarean delivery in 37 cases with anxiety condition, and the cesarean section rate was 83.78%. The intrapartum bleeding amount was （245.5±35.6） mL, which was evidently higher than the normal pregnancy. The difference between two groups was evident （P〈0.05）. The difference for every stage of labor and total labor time between two groups was not evident （P〉0.05）. Apgar score of one-minute newborn of the pregnancy with normal condition was higher than that of the anxiety group. The incidence rate of fetal distress and neonatal asphyxia were 10.81% and 10.81%, which was higher than that of the normal group. The difference between two groups was evident （P〉0.05）. Conclusion The relationship between prenatal anxiety of the pregnancy and the delivery outcome is positive. For the reasons for prenatal anxiety of the pregnancy, taking specific intervention can improve the delivery outcome.