黑龙江省牡丹江市686例妊娠期妇女心理健康状况调查及影响因素分析

Factors associated with psychological health status among 686 pregnant women in Mudanjiang,Heilongjiang Province

目的调查黑龙江省牡丹江市妊娠期妇女心理健康状况及其影响因素,为提高围产期保健质量提供科学依据。方法采用方便抽样方法,于2021年1—12月对黑龙江省牡丹江市3所三级甲等医院686名参加产科检查且计划建档分娩的妊娠期妇女进行问卷调查,采用90项症状清单量表、疲劳评定量表和匹兹堡睡眠质量指数对其进行测评,调查妊娠期妇女的心理健康、疲劳状况及睡眠质量等。采用单因素及多因素logistic回归分析探讨妊娠期妇女心理健康状况的影响因素。结果妊娠期妇女心理问题筛查阳性率为30.03%(孕早期31.91%,孕中期27.84%,孕晚期31.25%)。单因素分析结果显示,妊娠次数、夫妻感情、与公婆关系、疲乏程度、睡眠质量均会对妊娠期妇女心理健康产生影响(均P<0.05)。多因素logistic回归分析显示,有睡眠障碍,中度、重度疲乏者筛查出心理问题风险高;妊娠次数≥2次、夫妻感情很好、较好,与公婆关系良好及一般者筛查出心理问题风险低(均P<0.05)。结论妊娠期妇女心理健康受到睡眠质量、疲乏程度、夫妻感情、与公婆关系等因素的影响,心理健康状况不容忽视,应积极采取综合性干预措施改善其心理健康状态。

Objective To investigate psychological health status and factors associated with pregnant women in Mudanjiang,Heilongjiang Province,so as to provide scientific evidence for improving the quality of perinatal health care.Methods Convenient sampling was used to recruit 686 pregnant women who participated in obstetric examination and planned to deliver babies in 3 grade A tertiary hospitals as study subjects in Mudanjiang,Heilongjiang Province.Questionnaire survey was conducted to investigate psychological health status,fatigue and sleep quality among pregnant women through Symptom Check List 90(SCL-90),Fatigue Assessment Instrument and Pittsburgh Sleep Quality Index.Multivariate logistic regression analysis was used to explore the factors associated with mental health status among pregnant women.Results The average screening positive rate of psychological problems was 30.03%(31.91%in the first trimester,27.84%in the second trimester,and 31.25%in the third trimester).Univariate analysis showed that pregnant women’s mental health was affected by the number of pregnancies,couple sentiment,the relationship with parents-in-law,fatigue and sleep quality(all P<0.05).Multivariate logistic regression analysis showed that pregnant women with sleep disorders,moderate and severe fatigue had higher risk of screening for psychological problems,and the risk were lower in women≥2 pregnancies,good couple sentiment,and good relationship with parents-in-law(all P<0.05).Conclusion Pregnant women’s mental health can be affected by sleep quality,fatigue,couple sentiment,and the relationship with parents-in-law and other factors.Their mental health status can’t be ignored,and comprehensive intervention measures should be taken to improve their mental health.