新型冠状病毒肺炎疫情下不同孕期妇女心理健康状况及影响因素分析

Analysis of mental health status and its influencing factors of pregnant women in different trimesters of pregnancy during corona virus disease 2019 pandemic

目的 调查新型冠状病毒肺炎(COVID-19)疫情下不同孕期妇女心理健康状况及影响因素,为采取针对性心理干预措施提供依据.方法 采用网络问卷对2020年3月1日至31日在广西壮族自治区妇幼保健院就诊的孕妇进行横断面调查,并根据孕周分为早孕期、中孕期、晚孕期、足月妊娠.同时运用二分类Logistic回归模型分析孕妇心理健康的影响因素.结果共2041例合格孕妇完成调查问卷,无孕妇感染新型冠状病毒.调查孕妇中75.3% 及56.6% 无焦虑和抑郁症状16.4% 及27.4% 孕妇存在轻度焦虑和轻度抑郁,仅少数孕妇有中度及以上焦虑或抑郁症状.随孕期增加,中度及以上抑郁者比例下降(χ2=35.989,P<0.001);疫情下不同孕期孕妇担心的侧重点不同,孕中期孕妇更担忧产前检查增加感染风险(χ2=14.199,P<0.05),且内心恐慌的比例较其他孕期更高(χ2=10.879,P<0.05),孕晚期及足月孕妇则更担心疫情影响住院分娩(χ2=55.541,P<0.001)、家属陪产(χ2=34.681,P<0.001)及新生儿保健(χ2=22.814,P<0.001).Logistic回归分析显示,存在妊娠合并症是焦虑和抑郁的危险因素(OR=1.456,95%C I:1.010~2.098,P<0.05;OR=1.36,95%C I:1.027~1.801,P<0.05);居住地为乡镇者是焦虑症状的危险因素(OR=1.692,95%C I:1.029~2.783,P<0.05);有固定的工作是焦虑及抑郁的保护因素(OR=0.558,95%CI:0.378~0.824,P<0.05;OR=0.664,95%CI:0.493~0.894,P<0.05);相比孕早期,孕晚期及足月更不易出现抑郁症状(OR=0.695,95%CI:0.492~0.983,P<0.05;OR=0.429,95%CI:0.262~0.702,P<0.05).结论 COVID-19疫情下不同孕期妇女心理状态不同 ,根据孕期给予针对性的心理疏导 ,可促进孕妇心理健康.

Objective To investigate the mental health status and its influencing factors of women in different trimesters of pregnancy under the epidemic of corona virus disease 2019(COVID-19),and provide the basis for targeted psychological interventions.Methods A cross-sectional survey was conducted on pregnant women who visited the Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region from March 1 to 31,2020 through online questionnaire.And all of them were divided into the first,second,third trimester and full-term pregnancy according to the gestational week.Binary Logistic regression models were used to analyze the influencing factors of mental health status.Results A total of 2041 pregnant women participated in the survey and none of them were infected COVID-19.75.3%and 56.6%of pregnant women had no symptoms of anxiety and depression,and 16.4%and 27.4%had mild anxiety and depression,while only a few of them had moderate or more anxiety or depression symptoms.The proportion of people with moderate or greater depression decreased with the increasing of pregnancy term(χ~2=35.989,P<0.001).Different pregnancies women had different concerns.Women in the second trimester were more concerned about the risk of infection during prenatal testing(χ~2=14.199,P<0.05)and had more panic(χ~2=10.879,P<0.05),while women in the third trimester were more worried about the impact of the epidemic on hospital delivery(χ~2=55.541,P<0.05),parturition for company(χ~2=34.681,P<0.001)and newborn care(χ~2=22.814,P<0.05).As Logistic regression model shown,pregnancy complication was a risk factor for anxiety and depression(OR=1.456,95%CI:1.010-2.098,P<0.05;OR=1.36;95%CI:1.027-1.801,P<0.05),and living in a township was risk factor for anxiety symptoms(OR=1.692,95%CI:1.029-2.783,P<0.05).Having a job was a protective factor for anxiety and depression(OR=0.558,95%CI:0.378-0.824,P<0.05;OR=0.664;95%CI:0.493-0.894,P<0.05).Compared with the first trimester,pregnant women in the third trimester and at term were less likely to be depressed(OR=0.695,95%CI:0.492-0.983,P<0.05;OR=0.429,95%CI:0.262-0.702,P<0.05).Conclusion Women in different trimesters of pregnancy have different psychological state under the COVID-19 pandemic,giving targeted psychological intervention can promote their mental health.