Akiki Salwa, Avison William R, Speechley Kathy N, Campbell M Karen
Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada.
Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada; Department of Paediatrics, University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Department of Sociology, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
J Affect Disord. 2016 May 15;196:260-7. doi: 10.1016/j.jad.2016.02.016. Epub 2016 Feb 18.
The current state of research into antenatal anxiety is lacking in a comprehensive understanding of determinants. This study aims to expand knowledge in this area, with the main objective being to determine potential determinants of maternal antenatal state-anxiety.
Data used for this cross-sectional study were obtained from the Prenatal Health Project: a population cohort study of 2357 women in London, Ontario. 1992 women in their second trimester met inclusion criteria for this study. The primary hypothesis was that "feelings about the pregnancy" would be a determinant of antenatal state-anxiety after controlling for other potential covariates. The abbreviated version of the Spielberger State and Trait Anxiety Inventory (STAI) was used to measure state-anxiety. Univariate analyses and multiple linear regression were performed to identify variables predictive of state-anxiety.
Stress, feeling unsure/unhappy about the pregnancy and having low self-esteem, low mastery and low social support from one's partner and family were statistically significant determinants of state-anxiety during the second trimester. In addition, anxiety was found to be inversely related to gestational age.
The two main limitations of the study were the use of a self-report screening tool (STAI) as the measure of anxious symptoms rather than a clinical diagnosis, and possible recall bias of feelings about the pregnancy.
We concluded that how a woman feels about her pregnancy was a determinant of state-anxiety. This study contributes knowledge aiming to help women improve their mental health during pregnancy by identifying important determinants of state-anxiety.
目前对于产前焦虑的研究现状缺乏对决定因素的全面理解。本研究旨在扩展该领域的知识，主要目的是确定产妇产前状态焦虑的潜在决定因素。
本横断面研究使用的数据来自产前健康项目：安大略省伦敦市一项针对2357名女性的人群队列研究。1992名处于孕中期的女性符合本研究的纳入标准。主要假设是，在控制其他潜在协变量后，“对妊娠的感受”将是产前状态焦虑的一个决定因素。使用斯皮尔伯格状态-特质焦虑量表（STAI）的简版来测量状态焦虑。进行单因素分析和多元线性回归以确定预测状态焦虑的变量。
压力、对妊娠感到不确定/不开心、自尊水平低、掌控感低以及伴侣和家人给予的社会支持低，在统计学上是孕中期状态焦虑的显著决定因素。此外，焦虑与孕周呈负相关。
该研究的两个主要局限性是使用自我报告筛查工具（STAI）作为焦虑症状的测量方法而非临床诊断，以及对妊娠感受可能存在回忆偏差。
我们得出结论，女性对自己妊娠的感受是状态焦虑的一个决定因素。本研究有助于通过确定状态焦虑的重要决定因素，为帮助女性在孕期改善心理健康提供知识。
