362名孕妇孕期抑郁状态及影响因素研究

Study on Depression and Influencing Factors in 362Pregnant Women

目的调查孕妇孕期抑郁状况,研究孕期抑郁的影响因素。方法采用抑郁自评量表(Self-rating depression scale,SDS)和日常生活调查表开展问卷调查。以2016年6月-12月在北京、海南、安徽和云南4个地区调查的362名孕妇为研究对象,描述其人口学特征,采用χ2检验进行孕妇行为习惯对抑郁影响的单因素分析,采用Logistic回归分析进行孕妇孕期抑郁影响多因素分析。结果362例孕妇,抑郁患者102例(28.2%),其中轻度抑郁71例(19.6%),中度抑郁28例(7.7%),重度抑郁3例(0.8%)。孕妇怀孕前后行为习惯对抑郁状态影响单因素分析显示,妊娠前行为习惯对抑郁状态影响因素为失眠、饮酒、腿部抽筋、便秘或腹泻等消化功能紊乱和贫血,妊娠后行为习惯对抑郁状态影响因素为锻炼、失眠、熬夜、骨质疏松和便秘或腹泻等消化功能紊乱(P<0.05)。Logistic回归分析结果显示,孕期抑郁影响因素保护因素为孕后睡眠(OR=0.53,95%CI 0.40-0.68)、计划怀孕(OR=0.44,95%CI 0.25-0.75)、孕后锻炼(OR=0.71,95%CI 0.52-0.97)及孕周(OR=0.96,95%CI 0.94-0.99),危险因素为孕后便秘或腹泻等消化功能紊乱(OR=1.79,95%CI 1.11-2.90)、家庭人口(OR=1.24,95%CI 1.02-1.52)(P<0.05)。结论孕妇改变不良的行为习惯、是预防孕期抑郁发生的重要手段。为预防孕妇抑郁发生,建议孕期检查中实施精神障碍早期筛查,关注孕妇孕期情绪,适时进行评估及心理疏导,加强对孕妇的行为习惯进行管理,以降低孕期抑郁的发生率。

Objective To investigate the status of depression in pregnant women during pregnancy,and to analyze its influencing factors of depression.Methods Self-rating depression scale(SDS)and daily life questionnaire were used to conduct questionnaire survey.A total of 362pregnant women in Beijing,Hainan,Anhui and Yunnan from June to December 2016were selected as the research objects.Their demographic characteristics were described.Theχ2test was used for univariate analysis of the influence of behavior and habits of pregnant women on depression,and logistic regression analysis was used for multivariate analysis.Results Among 362pregnant women,there were 102depressed patients(28.2%),of which 71were mildly depressed(19.6%),28were moderately depressed(7.7%),and 3were severely depressed(0.8%).Univariate analysis of the influence of behavioral habits on depression in pregnant women before and after pregnancy showed the influencing factors of pre pregnancy behavior on depression were sleep disorder,drinking,leg cramps,constipation or diarrhea and anemia,the influencing factors of post pregnancy behavior on depression were exercise,sleep disorder,staying up,osteoporosis,constipation or diarrhea(P<0.05).The logistic regression analysis showed that the protective factors were sleep after pregnancy(OR=0.53,95%CI 0.40-0.68),planned pregnancy(OR=0.44,95%CI 0.25-0.75),exercise after pregnancy(OR=0.71,95%CI 0.52-0.97)and gestational age(OR=0.96,95%CI 0.95-0.97).The risk factors were constipation or diarrhea(OR=1.79,95%CI 1.11-2.90)and family structure(OR=1.24,95%CI 1.02-1.52)(P<0.05).Conclusion It is an important way to prevent the occurrence of depression during pregnancy for pregnant women to change their bad habits.In order to prevent the occurrence of depression in pregnant women,it is suggested to carry out early screening of mental disorders during pregnancy examination,pay attention to pregnant women’s emotions,conduct timely evaluation and psychological counseling,and strengthen the management of pregnant women’s behavior habits,so as to reduce the incidence of depression in pregnancy.