妊娠晚期孕妇心理健康状况、影响因素及其母婴结局

Mental health status and its influencing factors of pregnant women during the third trimester of pregnancy,and the maternal and infant outcomes

目的:探究妊娠晚期孕妇心理健康状况及相关因素,并分析其母婴结局。方法:本院2022年1月-2023年1月就诊的220例妊娠晚期孕妇为对象,通过90项症状清单(SCL-90)评价孕妇心理健康状况,据此分为良好组(SCL-90总分≤160分)与不良组(SCL-90总分>160分)。单因素及多因素logistic回归分析孕妇心理不良相关因素;对比两组母婴结局。结果:发放问卷220份,回收216份,有效问卷210份,有效应答率95.5%。210例SCL-90总分(137.15±20.35)分,>160分(阳性)75例(35.7%,不良组),≤160分(阴性)135例(64.3%,良好组)。两组家庭人均月收入、产次、睡眠质量、妊娠合并症、孕期被动吸烟、性格倾向、婚姻关系、本人对本次妊娠的态度、配偶对本次妊娠的态度、保胎治疗与否等存在差异(P<0.05)。logistic回归分析显示,家庭人均月收入<5000元、睡眠质量较差、有妊娠合并症、婚姻关系较差是妊娠晚期孕妇心理不良发生的危险因素(P<0.05),经产妇、配偶对本次妊娠高兴是其保护因素(P<0.05)。不良组剖宫产率(32.0%)高于良好组(17.8%)(P<0.05),产后出血、产褥期感染、新生儿窒息及新生儿低出生体重发生率两组无差异(P>0.05)。结论:妊娠晚期孕妇心理不良发生相关因素较多,可增加剖宫产率,不利于母婴结局,需加强妊娠期综合保健服务,针对性进行心理疏导。

Objective:To explore the mental health status and its related factors of pregnant women during the third trimester of pregnancy,and to analyze the maternal and infant outcomes.Methods:A total of 220 pregnant women during the third trimester of pregnancy from January 2022 to January 2023 were selected as subjects.The mental health status of the pregnant women was evaluated by 90 symptom check list(SCL-90),and these women were divided into group A(the women with SCL-90 total score≤160 points)and group B(the women with SCL-90 total score 160 points).Univariate and multivariate Logistic regression were used to analyze the related factors of the adverse mental health status of the women.The maternal and infant outcomes were compared between the two groups.Results:220 questionnaires were issued,and 216 questionnaires were returned.210 questionnaires were valid,with the effective response rate of 95.5%.The total score of SCL-90 of 210 women was 137.15±20.35 points,including 75(35.7%)women in group B and 135(64.3%)women in group A.There were significant differences in the per capita monthly income,the parity,the sleep quality,the pregnancy complications rate,the rate of passive smoking during pregnancy,the personality tendency,the marital relationship of women,the personal attitude towards this pregnancy of the women and their spouses,and the fetal protection treatment situation between the two groups(P<0.05).Logistic regression analysis showed that the family per capita monthly income 5000 Yuan,the poor sleep quality,the pregnancy,and the poor marital relationship of the women were the risk factors for their psychological distress during the third trimester of pregnancy(P<0.05),and the happiness for the pregnant women and their spouses were the protective factors for their psychological distress(P<0.05).The rate of cesarean section(32.0%)of the women in group B was significantly higher than that(17.8%)of the women in group A(P<0.05),but there were no significant differences in the incidences of postpartum hemorrhage and puerperal infection of the women,and the rates of neonatal asphyxia and low birth weight between the two groups(P>0.05).Conclusion:There are many factors related to the occurrence of psychological disorders of the pregnant women during the third trimester of pregnancy,which will increase their cesarean section rate and is not conducive to the maternal and infant outcomes.Therefore,comprehensive health care services for the women during pregnancy should be strengthened and the targeted psychological counseling should be provided.