孕妇产前抑郁焦虑的危险因素

Risk factors of prenatal depression and anxiety in pregnant women

目的：探讨孕妇产前抑郁、焦虑的相关危险因素,为产前抑郁、焦虑的早期筛查及临床干预提供理论支持。方法：选取昆明市妇幼保健院产前检查的孕妇2112人,采用爱丁堡产后抑郁量表（EPDS）、焦虑自评量表（SAS）于孕28周对其进行问卷调查。采用非条件logistic回归分析探讨产前抑郁、焦虑症状的相关危险因素。结果：孕28周抑郁症状检出率为25.4%,焦虑症状检出率为6.6%。Logistic回归分析显示,抑郁症状的危险因素为低年龄（OR=0.80,95%CI：0.68-0.94）、孕期非坚持工作（OR=1.18,95%CI：1.02-1.36）、对居住环境不满意（OR=1.50,95%CI：1.23-1.83）、期望生男孩（OR=0.86,95%CI：0.77-0.96）、非独子（OR=1.37,95%CI：1.06-1.76）、非计划内怀孕（OR=1.38,95%CI：1.10-1.72）;焦虑症状的危险因素为不满意居住环境（OR=1.64,95%CI：1.19-2.26）、与丈夫关系不融洽（OR=2.01,95%CI：1.20-3.37）、非计划内怀孕（OR=1.50,95%CI：1.05-2.14）。结论：本研究提示,年龄越小、孕期未坚持工作、对居住环境不满意、期望生男孩、孕妇非独子、非计划内怀孕的孕妇,越易患产前抑郁症;对居住环境不满意、与丈夫关系不融洽、非计划内怀孕的孕妇,越易患产前焦虑症。

Objective： To explore the related risk factors of antepartum depression and anxiety,and to provide the theoretical support for early screening,clinical intervention and prevention of antepartum depression and anxiety.Methods： At the time of 28 w eeks of prenatal examination,the Edinburgh Postnatal Depression Scale（ EPDS）,Self-Rating Anxiety Scale（ SAS） w ere used to survey 2112 pregnant w omen w ho w ere selected from Maternal and Child Health Hospital of Kunming City.Non conditional logistic regression analysis w as used to explore the related risk factors of prenatal depression and anxiety.Results： At the 28 w eeks of pregnancy,the detection rate of depression symptoms and anxiety symptoms w ere 25.4% and 6.6%.Logistic regression analysis show ed that the risk factors for perinatal depression symptoms w ere younger age（ OR = 0.80,95% CI： 0.68- 0.94）,not stick to w ork during pregnancy（ OR = 1.18,95% CI： 1.02- 1.36）,not satisfied w ith the living environment（ OR = 1.50,95%CI： 1.23- 1.83）,expectations for boys（ OR = 0.86,95% CI： 0.77- 0.96）,not only daughter（ OR = 1.37,95% CI：1.06- 1.76）,unplanned pregnancy（ OR = 1.38,95% CI： 1.10- 1.72）.The risk factors for perinatal anxiety symptoms w ere being not satisfied w ith the living environment（ OR = 1.64,95% CI： 1.19- 2.26）,not harmonious w ith her husband（ OR = 2.01,95% CI： 1.20- 3.37）,unplanned pregnancy（ OR = 1.50,95% CI： 1.05- 2.14）.Conclusion： It suggests that the pregnant w omen w ith younger age,less w orking during pregnancy,being not satisfied w ith the living environment,having more expectations for boys,being not only daughter,w ith unplanned pregnancy are more likely to suffer from antepartum depression; those being not satisfied w ith living environment,having harmonious relation w ith her husband,and w ith unplanned pregnancy are more likely to suffer from antepartum anxiety.