Hu H Q, Zhang J, Zhao W, Tian T, Huang A Q, Wang L L
Maternal and Children's Health Surveillance Department, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China.
Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Jan 6;51(1):47-52. doi: 10.3760/cma.j.issn.0253-9624.2017.01.010.
To estimate the prevalence of anxiety and depression symptoms during pregnancy among women from six districts of China and to explore the determinants of anxiety and depression during pregnancy. A cross-sectional study of maternal health status was conducted using the probability proportionate to size sampling method among pregnant women from six counties/districts in six provinces of China (Hebei, Liaoning, Fujian, Hunan, Sichuan and Yunnan). A questionnaire was completed by each of the women included in the study from August to December 2014. Women were recruited from three medical and health institutions with the most obstetrics patients in each district. A total of 4 210 pregnant women were included in the investigation. The hospital anxiety and depression (HAD) scale was applied to measure the symptoms of anxiety and depression in the pregnant women. Trend chi square test was used to assess the differences of anxiety and depression symptom among three trimesters. The multivariate logistic regression model was used to investigate potential contributory factors. The detection rates for anxiety symptoms and depression symptoms during pregnancy were 8.5% (357/4 210) and 12.5% (525/4 210), respectively. The prevalence of anxiety symptoms during the first, second and third trimesters were 7.9% (110/1 392), 8.8% (124/1 413) and 8.8% (123/1 405), respectively (χ=0.89, 0.419). The prevalence of depression symptoms during the first, second and third trimesters were 14.0% (195/1 392), 12.6% (178/1 413) and 10.8% (152/1 405), respectively (χ=6.52, 0.011). Multivariate logistic regression analysis showed an increased risk of anxiety and depression in women with an educational background of middle school rather than a college degree (1.94, 95% 1.44-2.63; 3.80, 95% 2.45- 5.91). Furthermore, compared with planned pregnancies, women with unplanned pregnancies had a higher risk of anxiety and depression (1.33, 95% 1.06- 1.66; 1.35, 95% 1.07- 1.71). Pregnant women who felt they lived in crowded residential conditions were at an increased risk of anxiety compared with those living in spacious residential environments (1.82, 95% 1.15- 2.87). Pregnant women with a household income of less than 10 000 yuan were at a higher risk of depression than living in a household with an income of ≥100 000 yuan (1.91, 95% 1.05-3.49). Similarly, multiparous women (≥2) were at higher risk of depression compared with nulliparous women (1.88, 95% 1.04- 3.41). The prevalence of anxiety and depression symptoms during pregnancy appears to be associated with several demographic factors, along with a women's obstetrical history. Lower educational background, unplanned pregnancy, the feeling of living under crowded residential conditions were all found to be risk factors for anxiety during pregnancy. Similarly, lower educational background, unplanned pregnancy, a lower household income (<10 000) and a greater number of previous deliveries were all risk factors for depression during pregnancy.
评估中国六个地区孕妇孕期焦虑和抑郁症状的患病率,并探讨孕期焦虑和抑郁的决定因素。采用按规模大小概率抽样方法,对中国六个省(河北、辽宁、福建、湖南、四川和云南)六个县/区的孕妇进行了一项关于孕产妇健康状况的横断面研究。2014年8月至12月,研究纳入的每位女性都完成了一份问卷。从每个地区产科患者最多的三家医疗卫生机构招募女性。共4210名孕妇纳入调查。采用医院焦虑抑郁(HAD)量表来测量孕妇的焦虑和抑郁症状。采用趋势卡方检验评估孕期三个阶段焦虑和抑郁症状的差异。使用多因素logistic回归模型研究潜在的影响因素。孕期焦虑症状和抑郁症状的检出率分别为8.5%(357/4210)和12.5%(525/4210)。孕早期、孕中期和孕晚期焦虑症状的患病率分别为7.9%(110/1392)、8.8%(124/1413)和8.8%(123/1405)(χ=0.89,P=0.419)。孕早期、孕中期和孕晚期抑郁症状的患病率分别为14.0%(195/1392)、12.6%(178/1413)和10.8%(152/1405)(χ=6.52,P=0.011)。多因素logistic回归分析显示,与大学学历女性相比,中学学历女性焦虑和抑郁风险增加(1.94,95%CI 1.44 - 2.63;3.80,95%CI 2.45 - 5.91)。此外,与计划妊娠相比,意外妊娠女性焦虑和抑郁风险更高(1.33,95%CI 1.06 - 1.66;1.35,95%CI 1.07 - 1.71)。与居住在宽敞居住环境中的孕妇相比,感觉居住环境拥挤的孕妇焦虑风险增加(1.82,95%CI 1.15 - 2.87)。家庭收入低于10000元的孕妇抑郁风险高于家庭收入≥100000元的孕妇(1.91,95%CI 1.05 - 3.49)。同样,经产妇(≥2次)与初产妇相比抑郁风险更高(1.88,95%CI 1.04 - 3.41)。孕期焦虑和抑郁症状的患病率似乎与一些人口统计学因素以及女性的产科病史有关。低学历、意外妊娠、感觉居住环境拥挤均被发现是孕期焦虑的危险因素。同样,低学历、意外妊娠、低家庭收入(<10000元)和更多的既往分娩次数均是孕期抑郁的危险因素。