产前抑郁的主要影响因素研究

Research on the main influencing factors of prenatal depression

目的:探讨经阴道分娩产妇产前抑郁的主要影响因素。方法:选取2019年3月1日至2019年9月30日在本院进行产检及入院待产的产妇为研究对象,入院时对研究对象进行爱丁堡抑郁量表评分及问卷调查,通过单因素卡方检验筛选出与EPDS评分显著关联的影响因素,纳入多因素logistics回归模型,得出产前抑郁独立危险因素及保护因素。结果:纳入828名孕妇,通过分析发现有胎儿性别期望、孕期发生重大事件、服用复合维生素、BMI过高或过低、工作状况、个人收入水平、流产次数≥1检验的P值分别是0.05、0.001、0.006、0.01、<0.05、<0.05、<0.05,均小于显著水平,有统计学意义;通过将以上指标挑出纳入多因素logistics回归模型,其中有胎儿性别期望、孕期发生重大事件、服用复合维生素、BMI过高或过低、坚持继续工作、流产次数≥1检验的P值均小于0.05,达显著水平,且其中有胎儿性别期望、孕期发生重大事件、流产史、BMI的OR值均大于1,而服用复合维生素和工作状况的OR值小于1。结论:有胎儿性别期望、孕期发生重大事件、流产次数≥1、BMI过高或过低均为产前抑郁的独立危险因素,服用复合维生素和坚持继续工作为保护因素。医务人员工作中应加强孕前及孕期宣教,建议产妇减少胎儿性别期望、孕期合理控制体质量、适当工作及运动,坚持服用复合维生素,同时加强产前抑郁筛查,积极开展心理疏导,减少产前抑郁的发生。

Objective:To explore the main influencing factors of prenatal depression in women who deliver vaginally.Methods:The puerpera who underwent maternity check-ups and were admitted to the hospital from March 1,2019 to September 30,2019 were selected as the research subjects.Upon admission,the subjects were scored on the Edinburgh depression scale and questionnaire survey,and passed the single factor chi-square test The influencing factors that are significantly related to EPDS scores are screened out,and the multi-factor logistics regression model is included to obtain independent risk factors and protective factors for prenatal depression.Results:828 pregnant women were included.Through analysis,it was found that there were fetal gender expectations,major events during pregnancy,taking multivitamins,BMI too high or too low,work status,personal income level,and the number of miscarriages≥1.The p-values of the test were 0.05 and 0.001,0.006,0.01,<0.05,<0.05,and<0.05,all of which are less than the significant level and are statistically significant;the above indicators are selected and included in the multi-factor logistics regression model,including fetal gender expectations,major events during pregnancy,and taking compound Vitamins,BMI is too high or too low,continue to work,the number of abortions≥1 test p value is less than 0.05,reaching a significant level,and there are fetal gender expectations,major events during pregnancy,abortion history,BMI OR value is greater than 1.The OR value of taking multivitamins and working conditions is less than 1.Conclusion:There are fetal gender expectations,major events during pregnancy,number of miscarriages≥1,high or low BMI are independent risk factors for prenatal depression,taking multivitamins and continuing to work are protective factors.Medical staff should strengthen pre-pregnancy and during pregnancy education.It is recommended that mothers reduce fetal gender expectations,reasonably control weight during pregnancy,appropriate work and exercise,insist on taking multivitamins,and strengthen prenatal depression screening,actively carry out psychological counseling,and reduce prenatal depression happened.