二次妊娠产妇抑郁情绪与血清25-羟基维生素D水平的关系以及对分娩方式的影响

Relationship between depression and serum 25-hydroxy vitamin D level in puerperae with the second pregnancy and its impact on mode of delivery

目的研究二次妊娠产妇抑郁情绪与血清25-羟基维生素D(25-OH-VD)水平的关系及对分娩方式的影响。方法选取从2016年2月-2018年2月于武汉市优抚医院进行分娩且伴有抑郁症的二次妊娠产妇100例记为研究组,另取同期于该院进行分娩不伴有抑郁症的二次妊娠产妇100例记为对照组。分别比较两组产妇焦虑自评量表(Self Rating Anxiety Scale,SAS)、汉密顿抑郁量表(Hamilton Depression Rating Scale,HAMD)评分以及血清25-OH-VD水平,并分析二次妊娠产妇抑郁情绪与SAS评分、血清25-OH-VD水平的相关性。此外,对比两组产妇分娩方式情况,并作多因素的logistic回归分析。结果研究组产妇SAS、HAMD评分相比对照组高(P<0.05),而血清25-OH-VD水平相比对照组低(P<0.05)。经Pearson相关性分析可得:二次妊娠产妇HAMD评分与SAS评分呈正相关(P<0.05),与血清25-OH-VD水平呈负相关(P<0.05)。研究组产妇顺产人数占比相比对照组低,而剖宫产人数占比相比对照组高(P<0.05)。经多因素logistic回归分析可得:SAS评分、HAMD评分较高以及血清25-OH-VD水平较低均是二次妊娠产妇不良分娩方式的独立危险因素(均P<0.05)。结论二次妊娠产妇抑郁情绪与血清25-OH-VD水平存在明显负相关关系,且抑郁情绪与清25-OH-VD水平的降低均会增加二次妊娠产妇不良分娩方式发生的风险。

Objective To study the association between depression and serum 25-hydroxy vitamin D(25-OH-VD)level in puerperae with the second pregnancy and its influence on delivery mode.Methods One hundred puerperae who suffered from depression during the second pregnancy and delivered in Wuhan Youfu Hospital from February 2016 to February 2018 were enrolled in the study group,whereas 100 puerperae who did not suffer from depression during the second pregnancy and simultaneously delivered in the same hospital were selected as the control group.The scores of Self-rating Anxiety Scale(SAS)and Hamilton Depression Rating Scale(HAMD)and serum 25-OH-VD level were compared between the two groups,and the correlation of depression with SAS score and serum 25-OH-VD level was analyzed.In addition,the mode of delivery was compared between the two groups,and multivariate logistic regression analysis was performed.Results The scores of SAS and HAMD in puerperae of the study group were significantly higher than those of the control group(both P<0.05),while the serum 25-OH-VD level was significantly lower in the study group than in the control group(P<0.05).Pearson correlation analysis showed that the score of HAMD in puerperae with the second pregnancy was positively correlated with the score of SAS(P<0.05),but negatively correlated with serum 25-OH-VD level(P<0.05).The proportion of spontaneous delivery was significantly lower in the study group than in the control group,while the proportion of cesarean section was significantly higher in the study group than in the control group(P<0.05).Multivariate logistic regression analysis showed that high SAS score,high HAMD score and low serum 25-OH-VD level were independent risk factors for poor delivery mode in puerperae with the second pregnancy(all P<0.05).Conclusions There is a significant negative correlation between depression and serum 25-OH-VD level in puerperae with the second pregnancy;moreover,depression and the decrease of serum 25-OH-VD level may increase the risk of poor delivery mode in them.