北京市围产营养门诊妊娠期糖尿病孕妇的焦虑、抑郁状况及相关影响因素

Anxiety,depression and their related influencing of gestational diabetes mellitus women in perinatal nutrition clinic in Beijing

目的 了解市北京市围产营养门诊妊娠期糖尿病（GDM）孕妇的焦虑、抑郁和社会支持情况.方法 于2016年1~8月按照地区代表性分层随机抽样方法,抽取北京市城区、郊区妇幼保健院、综合医院共8家围产营养门诊（其中城区三级综合医院3家、三级妇幼专科医院1家,郊区二级综合医院1家、妇幼专科医院3家）就诊的孕24~28周,首次诊断GDM的456例孕妇进行问卷调查.调查内容包括一般资料问卷、焦虑自评量表（SAS）、抑郁自评量表（SDS）和社会支持量表,并进行统计分析.结果 GDM孕妇的SAS得分为（57.12±4.61）分、SDS得分为（59.62±4.38）分,存在一定程度的焦虑、抑郁情绪.GDM孕妇的焦虑、抑郁分别与社会支持利用度、社会支持总分和主观支持呈负相关（P＜0.05）.高龄初产妇、孕前体质量指数（BMI）≥25kg/m2、受教育程度高、不良孕史、居住在城区是GDM孕妇发生焦虑、抑郁的高危因素,社会支持是GDM孕妇减少焦虑、抑郁状态发生的保护因素,而郊区GDM孕妇获得的社会支持低.结论 GDM孕妇易出现抑郁焦虑状态,建议在围产营养门诊开设健康教育课堂,提供心理辅导,加强社会支持,关注GDM孕妇的心理健康.

Objective To understand the anxiety,depression and social support of gestational diabetes mellitus（GDM）women in perinatal nutrition clinic in Beijing. Methods In accordance with the representative method of stratified random sampling,extraction,comprehensive urban suburban hospital,a to-tal of 456 pregnant women with GDM who were diagnosed for the first time in perinatal nutrition clinic at 24-28 gestational weeks in January to August,2016 were selected in this study for questionnaire survey. Survey includ-ed questionnaire on general information,Self-rating Anxiety Scale（SAS）,Self-Rating Depression Scale（SDS） and Social Support Scale. The results were statistically analyzed. Results The SAS score of pregnant women with GDM was（57.12±4.61）,SDS score was（59.62±4.38）. Anxiety and depression of GDM patients were negatively correlated with social support utilize degree,social support scores and subjective support（P〈0.05）. Elderly primi-para,pre-pregnancy BMI≥25kg/m2,higher education,adverse pregnancy,living in the city were risk factors of the occurrence of anxiety and depression in pregnant women with GDM. However,social support was a protective factor. And the social support of GDM pregnant women who lived in country was lower. Conclusions Pregnant women with GDM are easy to be anxiety and depression. It is suggested that health education classes should be set up in peri-natal nutrition clinic to provide psychological guidance and strengthen social support to pay attention to mental health of pregnant women with GDM.