中国孕产妇气质性乐观状况及动态变化情况分析

Status and dynamic changes of maternal dispositional optimism at different time points from pregnancy to postpartum in China

目的了解我国孕产妇在孕产期不同时点的气质性乐观状况和动态变化情况。方法选取2015年8月至2016年10月于山西、吉林、广东、北京开展的中国孕产妇心理健康队列研究(NSMCP)的1 210例孕产妇为研究对象。所有孕产妇均在孕13周前入组,持续随访至产后42天,通过气质性乐观量表收集、分析孕产妇乐观状况及变化情况。结果调查对象在各时点气质性乐观量表的平均得分均超过了15分,随着孕期周数增加,乐观量表得分呈现逐渐上升趋势,并在孕37周、产后3天两个时点分值最高,产后42天有所下降,差异有统计学意义(F=14.700,P<0.01);按照维度分别分析,随着妊娠过程的推进,乐观维度的得分呈现上升趋势,悲观维度的得分呈现降低趋势,且差异均有统计学意义(F值分别为14.508、4.945,P<0.05);进一步分析各维度内部得分情况,结果显示除了乐观维度的"对于我的未来,我总是相当乐观"和悲观维度的"我几乎不期待好事会发生在我头上"之外,其余各问题在各随访时点的平均得分均有显著性差异,且变化趋势与总维度变化趋势基本一致(F值分别为195.669、20.189、47.279、3.367,P<0.05)。结论我国孕产妇整体上呈现比较明显的乐观倾向,但各个孕产期具有差异性,建议加强对孕产妇气质性乐观状况的关注,进一步促进其身心健康。

Objective To investigate status and dynamic changes of maternal dispositional optimism at different time points from pregnancy to postpartum in China.Methods 1 210 pregnant women in National Prospective Cohort Study on the Mental Health of Pregnant Women in China(NSMCP) conducted in Shanxi, Jilin, Guangdong provinces and Beijing city.The pregnant women and puerparae were recruited in the study and followed up from the first trimester of pregnancy(before 13 weeks of gestation) till to 42 days′ postpartum.General demographic characteristics, the status and dynamic changes of maternal dispositional optimism in the cohort were collected and analyzed through baseline survey and the life orientation test-revised(LOT-R).Results The average scores of the subjects in LOT-R at 7 time points all exceeded 15 points.And the score had a gradual upward trend from early pregnancy to late pregnancy.The scores of the subjects in LOT-R at 37 weeks of gestation and at 3 days postpartum were much higher than those at any other time points, whereas that declined at 42 days postpartum, and the differences in LOT-R scores among 7 time points were statistically different(F=14.700,P<0.01).Referring to different items of each dimension of dispositional optimism, with increse of gestational week, the total LOT-R score and the average score of the optimistic dimension were gradually increased from early pregnancy to late pregnancy(F=14.508,P<0.05),while the average score of the pessimistic dimension decreased(F=4.945,P<0.05).Furthermore, through analysis of internal parts of optimistic and pessimistic dimensions, it indicated that the average scores of 4 issues except 2 issues(Q4&Q9) at all 7 time points were statistically meaningful(F=195.669,20.189,47.279 and 3.367 respectively, all P<0.05),and the dynamic changes in scores of each issue had similar tendency to the total score in the each dimension.Conclusion Chinese pregnant women present a relatively obvious optimistic trend, while there are differences in scores in optimistism at different time points from pregnancy to postpartum.Therefore it is recommended to pay more attention to the status and dynamic changes of maternal dispositional optimism to promote their mental health better.