晚期妊娠孕妇抑郁影响因素的路径分析

Path model analysis of influencing factors on depression in late pregnant women

目的探讨晚期妊娠抑郁的影响因素和相互关系。方法本研究为横断面调查研究,选择2018年1月至2019年3月在产科门诊进行产前检查的孕晚期女性进行问卷调查。收集孕妇的一般情况(涵盖生物、心理、社会等多因素),以医院焦虑抑郁量表评估孕期抑郁发生情况。采用SPSS24.0对比晚期妊娠女性抑郁组和非抑郁组之间的差异,采用AMOS21.0构建路径分析模型探索孕期抑郁的影响因素及相互关系。结果1059名晚期妊娠女性抑郁发生率为11.1%(118/1059)。构建的路径分析模型拟合效果较好(GFI=0.912,AGFI=0.901,RFI=0.920,CFI=0.931,RMSEA=0.033)。路径分析结果提示孕晚期焦虑、孕妇此次妊娠的心理准备、孕妇文化程度对孕晚期抑郁发生既有直接效应,也有间接效应(三个因素的总效应分别为0.381、-0.140和-0.156);睡眠状况和孕期居住方式仅产生直接效应(分别为0.136、0.107);居住区域、家庭月收入、社会支持程度仅产生间接效应(-0.175、0.103和0.102)。结论路径分析模型提示,在影响孕晚期女性抑郁的直接和间接因素中,孕妇的居住区域、家庭月收入、孕期居住方式与文化程度不易改变,可通过对焦虑、社会支持、睡眠状态及妊娠的心理准备等因素进行干预,减少抑郁发生。

Objective To survey the influencing factors for depression based on path model analysis in late pregnant women,and to explore the interrelationships for depression.Methods This cross-sectional study was conducted from January 2018 to March 2019.Antenatal women who came for a routine check-up at the antenatal clinic were invited to participate in the study.Collecting general information of pregnant women(including biological,psychological,social and other factors).The Hospital Anxiety and Depression Scale(HADS)was used to evaluate the incidence of depression during pregnancy.The differences between depression group and non-depression group were compared by SPSS 24.0,and the path analysis model was conducted by AMOS 21.0 to explore the influencing factors and interrelations of depression during pregnancy.Results A total of 1059 pregnant women completed questionnaire.The incidence of depression depression in third trimester women was 11.1%(118/1059).The path model fitting well with the sample data(GFI=0.912,AGFI=0.901,RFI=0.920,CFI=0.931,RMSEA=0.033).Anxiety,psychological preparation for the current pregnancy,and level of education had both direct and indirect effects on depression in third trimester women(the total effects of the three factors were 0.381,-0.140 and-0.156,respectively).Sleep quality and family member with whom the pregnant women living during pregnancy had only direct effects(the effects were 0.136 and 0.107,respectively).Residence,monthly income of family and social support had only an indirect influence on depression(the effects were 0.175,0.103,and 0.102,respectively).Conclusion Path model analysis suggests that the residence,monthly income of family,family member with whom the pregnant women living during pregnancy and educational level are not easy to change.It is suggested the incidence of depression is reduced by intervening the pregnancy anxiety,social support,sleep quality and the psychological preparation for pregnancy.