高龄孕产妇心理健康状况及妊娠结局调查分析

Investigation of mental health status and pregnancy outcome of pregnant women with advanced maternal age

目的分析高龄孕产妇的心理健康状况、妊娠合并症与并发症、分娩方式及围产儿结局。方法选取296例住院分娩的年龄≥35岁孕产妇作为高龄组、同期年龄<35岁孕产妇561例作为适龄组,采用一般资料调查表、90项症状(SCL-90)自评量表进行调查,比较2组孕产妇在心理健康水平、妊娠合并症与并发症、分娩方式及围产儿结局方面的差异。结果高龄组孕产妇在SCL-90总分及躯体化、抑郁、焦虑及恐怖因子的得分高于适龄组孕产妇(t=11.212、7.083、6.286、2.857,P<0.05或P<0.01);高龄组孕产妇糖尿病、胎膜早破、妊高症、前置胎盘、甲状腺功能减退症及产后出血的发生率高于适龄组(χ^2=8.443、6.840、4.278、7.383、5.742、3.865,P<0.05或P<0.01),剖宫产率高于适龄组(χ^2=36.533,P<0.01);高龄组孕产妇早产、新生儿窒息、低出生体重及围产儿死亡的发生率高于适龄组孕产妇(χ^2=6.736、4.865、5.529、8.549,P<0.05或P<0.01)。结论高龄孕产妇心理健康水平低于适龄孕产妇,且发生不良妊娠结局的风险增加。

Objective To analyze the mental health status,pregnancy complications and pregnancyinduced diseases,delivery modes and perinatal outcomes of pregnant women with advanced maternal age. Methods Two hundred and ninety six pregnant women with an advanced maternal age who gave birth in hospital were selected as the advanced-age group,and five hundred and sixty one ageappropriate pregnant women were selected as age-appropriate group. The general information questionnaire and self-rating Scale Symptom Checklist-90( SCL-90) were used to investigate and compare differences in maternal mental health, pregnancy complications and pregnancy-induced diseases,delivery modes and perinatal outcomes between two groups. Results The scores of SCL-90,somatization,depression,anxiety and terror factors were higher in advanced-age group than those in the age-appropriate group( t = 11. 212,7. 083,6. 286,2. 857,P < 0. 05 or P < 0. 01). The incidences of maternal diabetes,premature rupture of membranes,pregnancy-induced hypertension,placenta previa,hypothyroidism and postpartum hemorrhage were higher in advanced-age group than those in the age-appropriate group( χ^2= 8. 443,6. 840,4. 278,7. 383,5. 742,3. 865,P < 0. 05 or P < 0. 01). Likewise,the cesarean section rate was higher in advanced-age group than that in ageappropriate group( χ^2= 36. 533,P < 0. 01). The incidences of premature birth,neonatal asphyxia,low birth weight and perinatal death in the advanced age group was higher than that in the ageappropriate group( χ^2= 6. 736,4. 865,5. 529,8. 549,P < 0. 05 or P < 0. 01). Conclusion The mental health level of pregnant women with advanced maternal age is lower than that of age-appropriate pregnant women,and the risk of adverse pregnancy outcomes is increased.