孕期产前抑郁患病率及危险因素分析

Prevalence and risk factors of prenatal depression among pregnant women in different stages of pregnancy

目的探讨孕妇不同孕期的产前抑郁患病率及危险因素。方法选取2016年6月至2017年8月间来我院产科门诊进行产检的1 280例孕妇,收集孕妇的一般资料,并采用爱丁堡抑郁量表(EPDS)对产妇产前抑郁进行问卷调查,分析孕妇孕早期、孕中期、孕晚期的抑郁患病率,并探讨孕妇产前抑郁的危险因素。结果 1 280例孕妇中,有417例(32.58%)患有产前抑郁,孕早期、孕中期、孕晚期的产前抑郁患病率的差异无统计学意义(P>0.05);经多因素logistic回归分析显示,无工作(OR=3.842,95%CI:2.097～7.040)、夫妻关系不和睦(OR=4.242,95%CI:1.561～11.526)、流产史(OR=3.629,95%CI:1.094～12.043)、产前抑郁史(OR=6.573,95%CI:2.819～15.329)、性别期待(OR=2.171,95%CI:1.080～4.361)是孕妇产前抑郁的独立危险因素(均P<0.05)。结论孕妇不同孕期发生产前抑郁的可能性相当,妊娠期孕妇无工作、夫妻关系不和睦、有流产史、有产期抑郁病史、对胎儿性别有期待均是孕妇产前抑郁的危险因素,应针对这些因素进行预防。

Objective To investigate the prevalence and risk factors of prenatal depression among pregnant women in different stages of pregnancy. Methods A total of 1,280 pregnant women who came to our obstetrics outpatient clinic during June 2016 to August 2017 was enrolled in this study. The general data of pregnant women were collected and the prenatal depression was analyzed by the Edinburgh Depression Scale (EPDS). The prevalence of depression in early pregnancy, second trimester and third trimester was analyzed, and the risk factors of prenatal depression in pregnant women were explored. Results Among 1 280 pregnant women, there were 417 cases (32.58%) with prenatal depression. There was no significant difference in the prevalence of prenatal depression between first trimester, second trimester and third trimester ( P >0.05). Multivariate logistic regression analysis showed no work ( OR=3.842,95% CI: 2.097~7.040), disharmonious spouse relationship ( OR= 4.242 , 95% CI 1.561 ~11.526), abortion history( OR=3.629,95%CI: 1.094~12.043). prenatal depression history ( OR=6.573, 95% CI: 2.819 ~15.329), and gender role expectation ( OR=2.171, 95% CI :1.080~4.361) were independent risk factors for prenatal depression in pregnant women (all P <0.05). Conclusion Pregnancy women have similar possibility of prenatal depression in different pregnancy stages. No work, disharmonious spouse relationship, abortion history, history of maternity depression, and expectation of fetus gender are all risk factors of prenatal depression in pregnant women, which should be taken precaution.