新冠肺炎疫情期间合理营养、运动对孕妇心理健康的影响

Effect of proper nutrition and exercise on the mental health in pregnant women during the outbreak of COVID-19

目的了解COVID-19疫情爆发期间孕妇的心理健康状况,分析合理营养和运动对孕妇心理健康的影响。方法采用整群抽样,选取安徽省阜阳市、六安市、芜湖市的妇幼保健机构作为调查现场,采用问卷星调查孕妇的相关信息,共计收集问卷10466份。妇女心理健康状况采用突发公共卫生事件心理问卷(PQEEPH)评价。采用二项式Logistic回归模型,控制孕妇年龄、文化程度、职业、不良妊娠史等协变量,计算合理营养、运动与孕妇心理健康问题的OR值及95%的可信区间,分析孕早、中、晚期摄入足够营养和适当运动对孕妇心理健康的影响。结果共收集有效问卷10440份,调查对象平均年龄(28.3±4.3)岁,平均孕周(22.2±10.0)周。PQEEPH量表总的Cronbach′Alpha系数为0.94,各维度在0.64~0.88之间。以P_(75)为分界线,孕期摄入足够营养可显著降低抑郁(OR=0.46,95%CI:0.37~0.56)、神经衰弱(OR=0.53,95%CI:0.44~0.65)、恐惧(OR=0.7,95%CI:0.58~0.86)、强迫-焦虑(OR=0.49,95%CI:0.4~0.59)、疑病(OR=0.72,95%CI:0.58~0.89)的发生风险。以P_(75)为分界线,孕期进行适当运动可显著降低抑郁(OR=0.53,95%CI:0.47~0.59)、神经衰弱(OR=0.51,95%CI:0.45~0.56)、恐惧(OR=0.62,95%CI:0.56~0.69)、强迫-焦虑(OR=0.54,95%CI:0.48~0.69)、疑病(OR=0.63,95%CI:0.56~0.71)的发生风险。不同孕期足够的营养和适当的运动对孕产妇心理健康影响作用比较,差异均有统计学意义。结论重大传染病疫情期间孕妇遭受妊娠和疫情的双重影响,心理健康状况较差。足够的营养和适当的运动可有助缓解不良的心理情绪。

Objective To understand the mental health status and to explore the role of rational nutrition and exercise in promoting adverse psychological problems in pregnant women during the COVID-19 outbreak.Methods The public Health Emergency Psychological Questionnaire(PQEEPH)was used to assess the mental health of pregnant women who were collected from multiple maternal and child health care institutions in Fuyang,Lu′an,and Wuhu Cities,Anhui Province."Wenjuanxing"(www.wjx.cn),a web-based questionnaire,was used to collect information from 10466 respondents,in our survey.Odds Ratio(OR)and its 95%Confidence Interval(CI)were estimated by binomial logistic regression models after adjusting for age,education level,occupation,and adverse pregnancy history.Results In total,there were 10440 valid records of pregnant women,with an average age of(28.3±4.3)years old and an average gestational age of(22.2±10.0)weeks.The Cronbach′s Alpha coefficient of PQEEPH was 0.94,and the dimension-specific coefficients ranged from 0.64 to 0.88.The scores were converted into dichotomous variables according to a percentile(e.g,P90or P_(75)).Referring to P_(75),adequate nutrition intake was associated with a decreased level in depression(OR=0.46,95%CI:0.37-0.56),neurasthenia(OR=0.53,95%CI:0.44-0.65),fear(OR=0.7,95%CI:0.58-0.86),obsessive-anxiety(OR=0.49,95%CI:0.40-0.59),or hypochondria(OR=0.72,95%CI:0.58-0.89).Referring to P_(75),rational exercise was associated with a decreased level in depression(OR=0.53,95%CI:0.47-0.59),neurasthenia(OR=0.51,95%CI:0.45-0.56),fear(OR=0.62,95%CI:0.56-0.69),obsessive-anxiety(OR=0.54,95%CI:0.48-0.69),or hypochondria(OR=0.63,95%CI:0.56-0.71).Gestational week significantly modified the associations between nutrition or exercise and the psychological status of pregnant women during the COVID-19 outbreak.Conclusion The psychological status of pregnant women adversely affected by both gestation and epidemic outbreak.Adequate nutrition and rational exercise might improve the psychological mood.