高龄孕晚期初产妇分娩恐惧影响因素logistic回归模型构建

Construction of a Logistic Regression Model for Influencing Factors of DeliveryFear in Elderly Late Pregnant Primiparous Women

目的探究高龄孕晚期初产妇分娩恐惧影响因素,为制定针对性的孕前保健方案减轻产妇分娩恐惧状况提供参考。方法回顾性收集2021年10月至2023年9月在郑州大学第一附属医院规律产检且分娩的82例高龄孕晚期初产妇临床资料,根据是否发生分娩恐惧分为分娩恐惧组和非分娩恐惧组,比较两组临床资料,采用logistic多因素回归模型分析分娩恐惧的影响因素,构建预测模型。结果82例高龄孕晚期初产妇中分娩恐惧发生率为78.05%(64/82),其中41例轻度分娩恐惧,19例中度,4例重度。分娩恐惧组不孕症史产妇比率高于非分娩恐惧组,家庭人均月收入≥5000元、参加产前培训产妇比率低于非分娩恐惧组(P<0.05)。分娩恐惧量表(CAQ)与分娩自我效能感量表(CBSEI-C32)、简体中文版医疗社会支持量表(MOS-SSS-CM)、分娩准备度量表(CRS)评分均呈负相关(P<0.05)。不孕症史是高龄孕晚期初产妇分娩恐惧独立危险因素,家庭人均月收入≥5000元、参加产前培训及CBSEI-C32、MOS-SSS-CM、CRS评分升高是保护因素(P<0.05)。logistic回归模型为:Logit(P)=11.756+3.870 X_(1)-0.468 X_(2)-0.351 X_(3)-0.228 X_(4)-0.173 X_(5)-0.293 X_(6),其中X_(1)为不孕症史,X_(2)为家庭人均月收入,X_(3)为参加产前培训,X_(4)为CBSEI-C32评分,X_(5)为MOS-SSS-CM评分,X_(6)为CRS评分。该模型预测分娩恐惧的曲线下面积(AUC)为0.912,敏感度为85.11%,特异度89.07%。结论高龄孕晚期初产妇分娩恐惧影响因素复杂多样,包括不孕症史、家庭人均月收入、参加产前培训及CBSEI-C32、MOS-SSS-CM、CRS评分等,根据上述影响因素构建的logistic预测模型在预测分娩恐惧发生方面具有良好应用价值。

Objective To explore the influential factors of delivery fear in elderly late pregnant primiparous women,and to provide reference for making targeted pre-pregnancy health care programs to alleviate fear of childbirth.Methods The clinical data of 82 cases of elderly late pregnant primiparous women who were given birth during regular labor examination in the First Affiliated Hospital of Zhengzhou University from October 2021 to September 2023 were retrospectively collected.They were divided into fear of childbirth group and non-fear of childbirth group according to whether they had fear of childbirth,the clinical data of the two groups were compared,and the influencing factors of fear of childbirth were analyzed by logistic multi-factor regression model,and the prediction model was built.Results The incidence of delivery fear was 78.05%(64/82)in 82 cases of elderly late pregnant primiparous women,of which 41 cases were mild,19 cases were moderate and 4 cases were severe.The proportion of women with infertility history in the fear of childbirth group was higher than that in the non-fear of childbirth group,and the proportion of women with per capita household income≥5000 yuan and antenatal training was lower than that in the non-fear of childbirth group(P<0.05).The childbirth attitude questionnaire(CAQ)was negatively correlated with the scores of the short form of the Chinese childbirth self-efficacy inventory(CBSEI-C32),Chinese mandarin version of the medical outcomes study social support survey(MOS-SSS-CM)and childbirth readiness scale(CRS)(P<0.05).Infertility history was an independent risk factor for delivery fear in elderly late pregnant primiparous women,and family per capita income≥5000 yuan,participation in prenatal training and increased scores of CBSEI-C32,MOS-SSS-CM and CRS were protective factors(P<0.05).Logistic regression model was:Logit(P)=11.756+3.870 X_(1)-0.468 X_(2)-0.351 X_(3)-0.228 X_(4)-0.173 X_(5)-0.293 X_(6),where X_(1) was infertility history,X_(2) was family per capita monthly income,X_(3) was participation in prenatal training,X_(4) was CBSEI-C32 score,X_(5) was the MOS-SSS-CM score,and X_(6) was the CRS score.The area under the curve(AUC)for predicting fear of childbirth was 0.912,the sensitivity was 85.11%,and the specificity was 89.07%.Conclusion The influencing factors of delivery fear in elderly late pregnant primiparous women are complex and diverse,including infertility history,family per capita monthly income,participation in prenatal training,CBSEI-C32,MOS-SSS-CM,CRS score,etc.The logistic prediction model constructed according to the above influencing factors has good application value in predicting the occurrence of fear of childbirth.