孕早、中、晚期及产后睡眠质量自然转归及影响因素分析

Sleep quality and its natural outcome of Chinese pregnant and parturient women during perinatal period and the influencing factors

目的了解我国孕产妇在孕早、中、晚期及产后的睡眠质量和睡眠质量转归情况,并分析睡眠质量的影响因素,为有针对性地提高我国孕产妇睡眠质量提供参考依据。方法本研究于2015年8月至2016年10月在山西省妇幼保健院、吉林省妇幼保健院、广东省珠海市妇幼保健院、广东省深圳市妇幼保健院、北京市海淀区妇幼保健院共纳入1 210名孕产妇为研究对象。分别于研究对象孕早、中、晚期和产后收集一般人口学特征和睡眠质量等相关信息,并对其孕产期睡眠质量及转归情况进行分析。结果研究对象孕早期、孕中期、孕晚期和产后发生睡眠障碍的比例分别为45.7%、44.3%、53.4%和50.1%,其中孕中期睡眠障碍发生比例较低,孕晚期和产后的睡眠障碍比例较高,差异有统计学意义(χ^(2)=25.182,P<0.01);在孕早期存在睡眠障碍的调查对象中,48.1%的调查对象在整个研究过程均存在睡眠障碍;年龄偏大、未工作、非计划内怀孕、对居住环境满意度及婚姻状况评价一般、丈夫的支持力度一般、有遇到紧急或难处理的问题、不主动求助、既往有疾病史、孕早期生活满意度不高、孕早期悲观、压力中度及以上、存在焦虑及抑郁者,其睡眠质量较差,差异有统计学意义(χ^(2)值介于4.022~76.392之间,P<0.05)。结论孕早期存在睡眠障碍者,后续在孕中、晚期及产后出现睡眠障碍的风险较高,且睡眠质量与生理、心理、社会等多因素有关。

Objective To investigate sleep quality and its natural outcomes of pregnant and parturient women in China during perinatal period, and analyze influencing factors of sleep quality, so as to provide reference for improving sleep quality of the pregnant and parturient women.Methods From National Prospective Cohort Study on the Mental Health of Chinese Pregnant Women(NSMCP) conducted in Shanxi Provincial Maternity and Child Health Hospital, Jilin Provincial Maternity and Child Health Hospital, Zhuhai Municipal Maternity and Child Health Hospital of Guangdong Province and Shenzhen Municipal Maternity and Child Health Hospital of Guangdong Province, and Beijing Haidian District Maternity and Child Health Hospital from August 2015 to October 2016,1210 pregnant and parturient women were selected as study subjects.The general demographic characteristics and sleep quality and other related information of the subjects were collected in the early, middle, late pregnancy and early postpartum, and the sleep quality during pregnancy and early postpartum were analyzed.Results The proportions of the subjects with sleep disorders in the first trimester, the second trimester, the third trimester of pregnancy and postpartum were 45.7%,44.3%,53.4% and 50.1% respectively, showing that the incidence of sleep disorders in the second trimester of pregnancy was lower, and those in the third trimester of pregnancy and postpartum were both higher, and there was a statistically significant difference(χ^(2)=25.182,P<0.01).Among the surveyed subjects who had sleep disorders in the first trimester of pregnancy, 48.1% of them lasted sleep disorders throughout whole study process.Those subjects with older age, not working, unplanned pregnancy, average satisfaction with living environment and marital status, average husband′s support, urgent or difficult problems during pregnancy, not seeking help actively when meeting difficult problems, some disease history in the past, no high life satisfaction in the first trimester of pregnancy, pessimistic emotions in early pregnancy, moderate or above pregnancy stress, anxiety and depression all had poor sleep quality, and the differences were statistically significant(χ^(2)= 4.022~76.392,all P<0.05).Conclusion Those pregnant women with sleep disorders in the first trimester of pregnancy are at higher risk of sleep disorders in the second, the third of pregnancy and postpartum than those without sleep disorders in the first trimester of pregnancy.And sleep quality is related to many factors such as physiological, psychological and social factors.