产后妇女孕产疾患症状及相关因素分析

Prevalence and the correlation factors analysis of maternal morbidity for postpartum women

目的调查产后妇女孕产疾患症状情况,探讨产后孕产疾患躯体症状与生活功能损伤、焦虑、抑郁之间的关系。方法于2020年11月—2021年12月选取在复旦大学附属妇产科医院产后门诊完成42天复查的771例产后妇女进行问卷调查。采用中文版孕产疾患测量工具(WOICE产后问卷)调查产后妇女的躯体症状、生活功能损伤及心理状态,并绘制孕产疾患躯体症状网络图。结果771例研究对象自报的产后孕产疾患躯体症状涉及13大类共62个症状,平均症状数为(8.20±6.35)个,其中乳房症状(72.24%,557/771)、全身症状(61.61%,475/771)、运动系统症状(61.48%,474/771)的发生率最高。产后孕产疾患躯体症状数量是导致产后妇女心理状态改变和生活功能损伤的风险因素,高症状组(≥10个)发生产后抑郁、焦虑的风险分别是无症状组的19.986倍(95%CI:2.685~148.784)和11.693倍(95%CI:2.737~49.950);中症状组(5~9个)出现生活功能损伤的风险是无症状组的2.864倍(95%CI:1.452~5.649),且随着数量的增加,风险递增。结论孕产疾患躯体症状数量是产后妇女出现生活功能损伤和焦虑、抑郁心理的共同危险因素。

Objective To investigate the prevalence of maternal morbidity(MM)for postpartum women and to explore the relationship between postpartum adverse physical symptoms and life function impairment,anxiety and depression.Methods A total of 771 postpartum women who received postpartum health examination at Obstetrics and Gynecology Hospital,Fudan University and met the inclusion and exclusion criteria were selected and investigated for questionnaire survey from Nov 2020 to Dec 2021.They were required to use the Chinese version of Maternal WOICE Tool(postpartum questionnaire).The types and current status of women’s physiological symptoms,psychological and life function impairment were collected and a network diagram of physiological symptoms of maternal morbidity were drawn.Results The self-reported postpartum adverse physical symptoms of 771 participants involved 13 categories and 62 symptoms.The average self-reported number of maternal morbidity was 8.20±6.35.The top three self-reported maternal morbidities were breast symptoms(72.24%,557/771),constitutional symptom(61.61%,475/771)and movement system symptoms(61.48%,474/771).The number of postpartum maternal morbidity was a risk factor of postpartum women's psychological state and the life function impairment.The risk of postpartum depression in the high symptom group(≥10)was 19.986 times as much as that in the asymptomatic group(95%CI:2.685‒148.784).The risk of postpartum anxiety in the high symptom group(≥10)was 11.693 times as much as that in the asymptomatic group(95%CI:2.737‒49.950).Meanwhile,the risk of life function impairment in the symptomatic group(5-9)was 2.864 times as much as that in the asymptomatic group(95%CI:1.452‒5.649).And this risk rose with the increase of the number of symptoms.Conclusion The number of maternal morbidity is a common risk factor for life function impairment,anxiety and depression in postpartum women.