肥胖及孕期超重对孕产妇围生期心理健康的影响

Effects of pre-pregnancy obesity and overweight during pregnancy on the mental health of pregnant women over the perinatal period

目的分析肥胖及孕期超重对孕产妇围产期心理健康的影响。方法选取2019年1月—2019年12月在湖北省妇幼保健院接受围生期心理筛查的288例孕产妇为研究对象,利用一般资料调查表、焦虑自评量表(SAS)、抑郁自评量表(SDS)和症状自评量表(SCL-90)调查孕产妇的心理健康状况,分析肥胖及孕期超重对孕产妇围生期心理健康的影响,利用多因素一般Logistic回归分析孕产妇心理健康状况的影响因素。结果回收有效调查问卷275份,肥胖和孕期超重的发生率分别为17.82%和30.18%。孕前体重为肥胖和孕期超重孕产妇的SAS、SDS和SCL-90评分均高于其他组(P<0.05)。孕产妇心理状况异常发生率为24%。不同文化程度、是否为初产妇、有无不良孕产史和是否意外怀孕孕产妇的心理健康状况比较,差异无统计学意义(P>0.05),而不同年龄、孕前体重、孕期增重和家庭人均月收入孕产妇的心理健康状况比较,差异有统计学意义(P<0.05)。多因素一般Logistic回归分析结果显示,孕前体重[■=2.152(95%CI:1.457,3.178)]、孕期增重[■=9.226(95%CI:4.765,17.864)]和家庭人均月收入[■=0.524(95%CI:0.299,0.918)]是影响孕产妇心理健康状况的主要因素(P<0.05),其中孕前肥胖和孕期超重为危险因素,家庭人均月收入>4000元为保护因素,而年龄并非影响孕产妇心理健康状况的主要因素(P>0.05)。结论肥胖及孕期超重均是影响孕产妇负面情绪的主要因素,临床上应加强孕期体重管理,降低孕产妇负面情绪的发生率。

Objective To analyze the effects of pre-pregnancy obesity and overweight during pregnancy on the mental health of pregnant women over the perinatal period.Methods We selected 288 pregnant women who underwent perinatal psychological screening tests in our hospital from January 2019 to December 2019 as the subjects,using general information questionnaire,Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and Symptom Checklist-90(SCL-90)to investigate the mental health of pregnant women and to analyze the effects of pre-pregnancy obesity and overweight during pregnancy on the mental health of them.Multivariate Logistic regression analysis was performed to explore the factors affecting the mental health of pregnant women.Results A total of 275 valid questionnaires were collected,and the incidences of pre-pregnancy obesity and overweight during pregnancy were 17.82%and 30.18%,respectively.The scores of SAS,SDS and SCL-90 in pregnant women with pre-pregnancy obesity and overweight during pregnancy were significantly higher than those of others(P<0.05).The incidence of psychological dysregulation in pregnant women was 24%,and the mental health status of pregnant women was not affected by their education level,whether they were primiparous,and the history of abnormal pregnancy or unplanned pregnancy(P>0.05).However,the metal health status was different among pregnant women with distinct age,pre-pregnancy weight,weigh gain during pregnancy,and household monthly income per person(P<0.05).The multivariate Logistic regression analysis showed that pre-pregnancy weight[■=2.152(95%CI:1.457,3.178)],weight gain during pregnancy[■=9.226(95%CI:4.765,17.864)]and household monthly income per person[■=0.524(95%CI:0.299,0.918)]were the main factors affecting the mental health of pregnant women,among which pre-pregnancy obesity and overweight during pregnancy were risk factors,while the household monthly income per person more than 4,000 yuan was a protective factor(P<0.05).In addition,the mental health of pregnant women was not affected by the age(P>0.05).Conclusions Pre-pregnancy obesity and overweight during pregnancy are the main factors contributing to negative emotions of pregnant women.Thus,the weight management should be emphasized in clinical practice to reduce the incidence of negative emotions in pregnant women.