泰州地区孕妇心理健康状况调查

Survey on mental health of pregnant women in Taizhou

目的探讨泰州地区孕妇心理健康状况及影响因素。方法选取2016年1月至2017年12月,泰州市妇幼保健所产检的孕妇,采用选择汉密顿焦虑量表(HAMA)、爱丁堡抑郁量表(EPDS)、心率变异性测试孕妇心理健康状况。分析年龄、居住地、文化程度、配偶文化程度、经济收入、孕周、早孕反应、不良孕产史、产次对孕妇心理健康状况的影响。结果共调查1217名孕妇,HAMA阳性率15.69%(191/1217),年龄[OR(95%CI)2.90(2.06~4.09)];居住地[OR(95%CI)0.60(0.42~0.85)];文化程度[OR(95%CI)0.56(0.47~0.67)];经济收入[OR(95%CI)2.13(1.71~2.65)];早孕反应[OR(95%CI)0.73(0.56~0.96)];产次[OR(95%CI)0.47(0.34~0.65)]是其影响因素。EPDS阳性率12.74%(155/1217),年龄[OR(95%CI)2.65(1.83~3.83)];居住地[OR(95%CI)0.49(0.34~0.71)];经济收入[OR(95%CI)1.40(1.13~1.74)];孕周[OR(95%CI)1.97(1.35~2.88)];不良孕产史[OR(95%CI)3.98(2.00~7.90)];产次[OR(95%CI)0.60(0.42~0.84)]是其影响因素。心率测试阳性率3.29%(40/1217),年龄[OR(95%CI)2.50(1.27~4.92)];孕周[OR(95%CI)2.76(1.45~5.24)];早孕反应[OR(95%CI)1.65(1.05~2.61)]是其影响因素。心理健康阳性率23.25%(283/1217),年龄[OR(95%CI)3.18(2.34~4.31)];居住地[OR(95%CI)0.47(0.34~0.65)];文化程度[0.62(0.53~0.73)];经济收入[OR(95%CI)2.26(1.85~2.76)];孕周[OR(95%CI)1.75(1.26~2.43)];早孕反应[OR(95%CI)0.70(0.55~0.89)];不良孕产史[OR(95%CI)2.44(1.21~4.88)];产次[OR(95%CI)0.48(0.35~0.64)]是其影响因素。结论泰州地区孕妇心理健康状况问题较为常见,应对健康状况高危的孕妇进行个体化健康教育干预。

Objective To understand the status of mental health of pregnant women in Taizhou and to analyze its influencing factors.Methods A questionnaire survey was conducted among 1217women with their first pregnancies who did regular pregnancy examinations in Taizhou Maternal and Child Health Care Center from January 2016to December 2017.The status of mental health was evaluated using Hamilton Anxiety Scale(HAMA),Edinburgh Depression Scale(EPDS)and Heart Rate Variability(HRV).Univariate and multivariate logistic regression was used for influencing factors analysis.Results Among 1217pregnant women,the overall prevalence of anxiety was 15.69%(191/1217)and age[OR(95%CI)2.90(2.06-4.09)],place of residence[OR(95%CI)0.60(0.42-0.85)],education[OR(95%CI)0.56(0.47-0.67)],income[OR(95%CI)2.13(1.71-2.65)],early pregnancy sickness[OR(95%CI)0.73(0.56-0.96)],and parity[OR(95%CI)0.47(0.34-0.65)]were found to be influencing factors of anxiety.The prevalence of depression was 12.74%(155/1217)and age[OR(95%CI)2.65(1.83-3.83)],residence[OR(95%CI)0.49(0.34-0.71)],income[OR(95%CI)1.40(1.13-1.74)],gestational week[OR(95%CI)1.97(1.35-2.88)],unsuccessful pregnancy and delivery experience[OR(95%CI)3.98(2.00-7.90)],and parity[OR(95%CI)0.60(0.42-0.84)]were influencing factors.The prevalence of irregular heart rate was 3.29%(40/1217)and age[OR(95%CI)2.50(1.27-4.92)],gestational week[OR(95%CI)2.76(1.45-5.24)]and early pregnancy sickness[OR(95%CI)1.65(1.05-2.61)]were the influencing factors.23.25%(283/1217)of pregnant women had mental health problem and univariate analysis showed age[OR(95%CI)3.18(2.34-4.31)],residence[OR(95%CI)0.47(0.34-0.65)],education[OR(95%CI)0.62(0.53-0.73)],income[OR(95%CI)2.26(1.85-2.76)],gestational week[OR(95%CI)1.75(1.26-2.43)],early pregnancy sickness[OR(95%CI)0.70(0.55-0.89)],unsuccessful pregnancy and delivery experience[OR(95%CI)2.44(1.21-4.88)]and parity[OR(95%CI)0.48(0.35-0.64)]were influencing factors.Conclusions More than a quarter of pregnant women have mental health problem in Taizhou.Therefore,individualized health education should be provided to pregnant women,especially those with high risk of mental health issues.