孕产期不同阶段的抑郁、焦虑症状筛查及相关因素调查

Depressive and anxiety symptoms during different stages of perinatal period and influencing factors

目的探讨孕产期不同阶段抑郁、焦虑发病状况及其影响因素。方法采用方便抽样方法,于2017年10月至2018年1月在北京市抽取妊娠不同时期孕产妇共620名作为调查对象,自编一般资料调查表,9项患者健康问卷(PHQ-9)、7项广泛性焦虑障碍量表(GAD-7),分析孕产期抑郁、焦虑状况及其影响因素。结果本研究发现孕产期抑郁症状检出率为11.33%(68/600),焦虑症状检出率为23.83%(143/600),抑郁伴焦虑症状检出率为7.83%(47/600)。孕早、中、晚期抑郁症状的检出率分别为15.58%(12/77)、10.26%(8/78)、4.00%(3/75),差异无统计学意义(P>0.05);产后6个月以内、6个月以上的抑郁症状的检出率为8.75%(14/160)、14.76%(31/210),差异无统计学意义(P>0.05)。孕期焦虑症状检出率分别为28.57%(22/77)、23.08%(18/78)、9.33%(7/75),差异有统计学意义(P<0.05);产后分别为25.63%(41/160)、26.19%(55/210),差异无统计学意义(P>0.05)。Logistic回归分析发现,孕产期抑郁症状的危险因素为非全职(OR:2.27,95%CI:1.33~3.86,P<0.01);孕产期焦虑症状的危险因素为月收入≤5000元(OR:1.60,95%CI:1.02~2.50,P<0.05)、非全职(OR:1.85,95%CI:1.15~2.97,P<0.05)。结论PHQ-9及GAD-7可有效检出孕产期抑郁、焦虑症状。孕期和产后均有一定比例的抑郁、焦虑症状。孕产期抑郁、焦虑症状的共同危险因素为工作不稳定。

Objectives To investigate the prevalence of depression and anxiety during the perinatal period and its influencing factors.Methods A total of 620 pregnancies at different stages of perinatal period were collected by convenience sampling method in Beijing from October 2017 to January 2018.All the subjects were surveyed by general information questionnaires,Patients' Health Questionnaire-9(PHQ-9) and Generalized Anxiety Disorder-7(GAD-7) to analyze perinatal depression,anxiety and its influencing factors.Results In this study,the detection rate of depressive symptoms in perinatal period was 11.33%(68/600),anxiety symptoms 23.83%(143/600),and depression with anxiety 7.83%(47/600).The detection rate of depressive symptoms in early,middle and late stage of pregnancy was 15.58%(12/77),10.26%(8/78),and 4.0%(3/75) respectively,with no statistically significant difference(P> 0.05).The detection rate of depressive symptoms was 8.75%(14/160) and 14.76%(31/210) within 6 months and 6 months after delivery,with no statistically significant difference(P>0.05).The detection rate of prenatal anxiety was 28.57%(22/77),23.08%(18/78) and 9.33%(7/75) respectively,and the difference was statistically significant(P< 0.05).Postpartum was 25.63%(41/160),26.19%(55/210),and the difference was not statistically significant(P> 0.05).Logistic regression analysis found that the risk factors for depressive symptoms in perinatal period were not full-time(OR:2.27,95%CI:1.33-3.86,P< 0.01).The risk factors of perinatal anxiety symptoms were monthly income lower than 5 000 yuan(OR:1.60,95%CI: 1.02-2.50,P<0.05),and non-full-time(OR:1.85,95%CI:1.15-2.97,P<0.05).Conclusions PHQ-9 and GAD-7 can effectively detect depression and anxiety symptoms in perinatal period.There is a certain proportion of depression and anxiety in pregnancy and postpartum.A common risk factor for perinatal depression and anxiety symptoms is job insecurity.