妊娠高血压疾病患者心理社会应激状况及生活质量的调查

Survey of pregnancy psychosocial stress status and quality of life of patients with pregnancy-induced hypertension

目的调查分析妊娠高血压疾病患者心理社会应激状况、生活质量及对妊娠结局。方法选择2012年3月～2013年2月杭州市余杭区妇幼保健院就诊的93例妊娠高血压疾病患者（妊高征组）和90例健康产妇（健康对照组）为研究对象，采用症状自评量表（SCL-90）、简明健康状况调查表（SF-36量表）对两组孕妇进行问卷调查，并随访妊高征组孕妇妊娠结局。结果妊高征组SCL-90量表躯体化、抑郁、焦虑、敌对、强迫症状、恐惧、人际关系敏感症状评分及总分均高于健康对照组，差异有统计学意义（均P〈0．05）；妊高征组担心自我、担心胎儿健康、担心分娩的焦虑状态评分及总分均高于健康对照组，差异有统计学意义（均P〈0．05）；妊高征组生活质量显著低于健康对照组，SF-36量表生理职能、生理功能、活力、情感职能、心理健康、总体健康评分及总分明显低于健康对照组，差异有统计学意义（均P〈0．05）。妊高征组SCL-90和SF-36的Ⅰ、Ⅱ组子痫、早产、胎儿窘迫、新生儿窒息、围生期胎儿死亡等不良妊娠结局发生率比较，差异均有统计学意义（均P〈0．05）；妊娠相关焦虑的Ⅰ、Ⅱ组子痫（4．26％比8．70％）、早产发生率（2．13％比13．04％）比较，差异均有统计学意义（均P〈0．05）。结论妊娠高血压疾病患者存在多种心理健康问题，生活质量较低，对自我、胎儿健康及分娩存在较严重焦虑，且心理社会应激状况及生活质量对妊娠结局有影响。

[Abstract] Objective To investigate the pregnancy psychosocial stress conditions, quality of life and the impact on pregnancy outcome of patients with pregnancy-induced hypertension. Methods 93 cases of pregnancy-induced hyper-tension of pregnancy （PIH group） and 90 healthy women （healthy control group） from March 2012 to February 2013 in Yuhang District Maternal and Child Care Service Centre were selected as study objects, the SCL-90 and SF-36 were used to conduct the questionnaire survey among all the pregnant women, and the outcomes of pregnant women in PIH group were followed up. Results SCL-90 scale somatization, depression, anxiety, hostility, obsessive-compulsive symp- toms, fear, interpersonal sensitivity symptoms scores and the total scores of PIH group were higher than those of healthy control group, the differences were statistically significant （all P 〈 0.05）. The worried about themselves, worried about fetal health, worried about childbirth anxiety scores and the total score of PIH group were higher than those of healthy control group, the differences were statistically significant （all P 〈 0.05）. The quality of life of PIH group was significantly lower than that of the healthy control group, the SF-36 scale RP, PF, VT, RE, MH, GH score and the total score of PIH group were lower than those of the healthy control group, the difference were statistically significant （all P 〈 0.05）. Incidence of eclampsia, preterm birth, fetal distress, neonatal asphyxia, perinatal fetal death and other adverse pregnancy outcomes in group Ⅰ, Ⅱ of SCL-90 and SF-36 in PIH group were statistically significant differences （all P 〈 0.05） , group Ⅰ, Ⅱ of pregnancy-related anxiety eclampsia, eclampsia gravidarum （4.26% vs 8.70%） ,preterm birth incidence （2.13% vs 3.04%） were statistically significant differences （all P 〈 0.05）. Conchlsion There are a variety of pregnancy mental health problems in patients with pregnancy-induced hypertension, lower quality of life, the serious anxiety of self, fetal health and childbirth, stress and psychosocial status and quality of life impact on the pregnancy outcome.