云南部分农村妇女不同孕期感知压力影响因素分析

Perceived prenatal stress and its correlates in three trimesters among part of the rural women of Yunnan

目的探讨云南省农村地区妇女不同孕期感知压力现状及其影响因素。方法基于2014年7月起建立的云南省某农村地区孕妇环境暴露的出生队列,以云南省某农业县两个乡镇确诊怀孕的560名妇女为研究对象,分别在孕早、中、晚期对其进行问卷调查,采用10项条目感知压力量表(PSS10)测量。使用重复测量方差分析妇女孕早、中、晚期感知压力现状的差异,并用χ^2检验和Logistic回归分析感知压力可能的影响因素。结果妇女孕早、中、晚期感知压力平均得分分别为14.69±4.20、14.63±4.23和14.68±3.98,差异无统计学意义(F=0.108,P>0.05)。Logistic回归分析显示25岁及以上妇女高感知压力发生风险较25岁以下妇女发生风险高,在孕早期OR=1.700,P=0.004;孕中期OR=1.493,P=0.030;孕晚期OR=1.440,P=0.050。丈夫文化程度高,孕早期和孕中期高感知压力的发生风险增高(OR=1.530~2.180,均P<0.05);既往有不良孕产史(OR=2.567,P<0.01)妇女孕晚期高感知压力的发生风险增高;汉族妇女在不同孕期高感知压力发生风险较少数民族高(OR值分别为0.600、0.476、0.531,均P<0.05)。结论农村地区孕妇感知压力普遍存在,程度较高,其年龄越大、丈夫文化程度高和既往有不良孕产史是高感知压力发生的独立危险因素,汉族孕妇较少数民族孕妇有更高水平的感知压力。

Objectives To understand the perceived prenatal stress status in the three trimesters and to explore its correlates among rural pregnant women.Methods A total of 560 pregnant women in the first trimester were recruited in this study.A questionnaire survey was conducted to collect the social demographic characteristics and previous health information of the participants and perceived stress were measured by Perceived Prenatal Stress 10(PSS10).Repeated measurement analysis of variance was used to test the difference of prenatal stress among the three trimesters.Chi-square test and logistic regression analysis were used to analyze the correlates of perceived prenatal stress among women.Results The average PSS10 scores in three trimesters were 14.69±4.20,14.63±4.23,14.68±3.98,respectively,and the differences of PSS10 scores among three trimesters were not statistically significant(F=0.108,P>0.05).Logistic regression analysis showed that the women at age of 25-years and above had higher risk of high perceived prenatal stress than those below 25-year old(OR=1.700,P=0.004 in the first trimester,OR=1.493,P=0.030 in the second trimester,and OR=1.440,P=0.050 in the third trimester).The risk of perceived prenatal stress among the women whose husband had higher educational level was higher in the first and the second trimester.The women who experienced abnormal pregnancy increased the risk of perceived stress(OR=2.567,P<0.01) in the third trimester.The Han pregnant women had a higher risk of high perceived stress than minority women in the three trimesters(OR=0.600,0.476,0.531,P<0.05).Conclusion The perceived stress level of pregnant women is high in rural area of Yunnan.The older age of pregnant women,the higher level of education l of their husband and having experience of adverse pregnancy are the independent risks for higher prenatal perceived stress.The pregnant women of Han nationality showed a higher level of perceived prenatal stress than pregnant women of minorities.