9516例妊娠早期妇女焦虑和抑郁症状与孕产史的关系

The associations of anxiety and depression symptoms with pregnancy history among 9516 early pregnant women

目的探讨孕产史对妊娠早期妇女焦虑和抑郁症状发生率的影响。方法采用广泛焦虑量表(generalized anxiety disorder-7 items,GAD-7)和患者健康问卷(patient health questionaire-9 items,PHQ-9)评测重庆市妇幼保健院产科门诊2020年2―10月建档的9516例妊娠早期妇女焦虑和抑郁症状。单因素分析检测焦虑和抑郁症状的影响因素,logistics回归分析模型进一步分析孕产史对焦虑和抑郁症状发生率的影响。结果妊娠早期妇女焦虑和抑郁症状检出率分别为18.9%和47.5%。单因素分析显示年龄、孕前BMI、吸烟史、饮酒史、过敏史、产次和流产次数与焦虑和抑郁症状相关(均有P<0.001)。校正混杂因素后,logistics回归分析模型分析显示相较于再产妇,初产妇焦虑症状的发生率增高(OR=1.16,95%CI:1.01~1.33,P=0.031);流产史增加焦虑(OR=1.26,95%CI:1.13~1.41,P<0.001)和抑郁(OR=1.19,95%CI:1.09~1.29,P<0.001)症状的发生风险。结论初次生产和流产史是妊娠早期妇女焦虑和抑郁症状的重要危险因素。

Objective To investigate the effect of pregnancy history on the incidence of depression and anxiety symptoms among early pregnant women.Methods A total of 9516 early pregnant women were recruited from Obstetric Clinic of the Chongqing Maternal and Child Health Hospital during February 2020 to October 2020.Anxiety and depression symptoms were evaluated by Generalized Anxiety Disorder-7 items(GAD-7)and Patient Health Questionaire-9 items(PHQ-9),respectively.Univariate analyses were used to detect the influencing factors of anxiety and depression symptoms,and logistic analyses were used to evaluate the effect of pregnancy history on the incidence of depression and anxiety symptoms.Results The rates of anxiety and depression symptoms were 18.9%and 47.5%among early pregnant women,respectively.Results of univariate analyses indicated that age,BMI(before pregnancy),smoking history,alcohol drinking history,allergies,parity,and abortion number were related to anxiety and depression symptoms.After adjusting for confounders,logistic analyses showed that primipara had higher risk of anxiety symptoms than multipara(OR=1.16,95%CI:1.01-1.33,P=0.031).Abortion was associated with increased odds for anxiety(OR=1.26,95%CI:1.13-1.41,P<0.001)and depression(OR=1.19,95%CI:1.09-1.29,P<0.001)symptoms,respectively.Conclusion Our study suggested that primipara and abortion were important risk factors for depression and anxiety symptoms in early pregnant women.