Din Zia Ud, Ambreen Sadaf, Iqbal Zafar, Iqbal Mudassar, Ahmad Summiya
Department of Human Nutrition, The University of Agriculture, Peshawar, Pakistan.
Department of Agricultural Chemistry, The University of Agriculture, Peshawar, Pakistan.
Noro Psikiyatr Ars. 2016 Jun;53(2):152-157. doi: 10.5152/npa.2015.10235. Epub 2016 Jun 1.
An increasing number of evidence has demonstrated that poor antenatal psychological health can lead to adverse pregnancy outcomes. Studies conducted in various countries demonstrated a wide range of factors associated with psychological distress during pregnancy.
A cross-sectional study was conducted between September 2011 and December 2012 in Peshawar, north-west Pakistan. A total of 230 women in their third trimester of pregnancy fulfilled the inclusion criteria. The antenatal psychological health status of women was measured using the Depression Anxiety Stress Scale. Relevant data regarding health and demographic-socioeconomic status were collected through personal interviews using standardized questionnaires.
Overall, 45% (n=104) of women exhibited symptoms for composite depression, anxiety, and stress (composite DAS). In the univariate analysis, maternal age, husband support, monthly income, family size, stressful life events, lack of confidence, domestic violence, and pregnancy-related concerns were strongly associated with antenatal composite DAS (p<0.01). The association of maternal composite DAS symptoms with age, monthly income, family size, and lack of confidence remained significant in the multivariate analysis (p<0.01).
A major proportion of women exhibited symptoms of antenatal composite DAS, and various factors were found to be related to their psychological distress. A young maternal age, low husband support, low income, large family size, adverse life events, lack of confidence, pregnancy-related concerns, and domestic violence were stronger determinants of poor antenatal psychological status. The study findings concluded that policymakers at the government level should launch special intervention programs to improve maternal perinatal mental and psychological health at the community level.
越来越多的证据表明，产前心理健康状况不佳会导致不良妊娠结局。在各个国家进行的研究表明，孕期心理困扰与多种因素有关。
2011年9月至2012年12月在巴基斯坦西北部的白沙瓦进行了一项横断面研究。共有230名处于妊娠晚期的妇女符合纳入标准。使用抑郁焦虑压力量表测量妇女的产前心理健康状况。通过使用标准化问卷进行个人访谈收集有关健康和人口社会经济状况的相关数据。
总体而言，45%（n = 104）的妇女表现出综合抑郁、焦虑和压力症状（综合DAS）。在单因素分析中，产妇年龄、丈夫支持、月收入、家庭规模、生活压力事件、缺乏自信、家庭暴力和与妊娠相关的担忧与产前综合DAS密切相关（p < 0.01）。在多因素分析中，产妇综合DAS症状与年龄、月收入、家庭规模和缺乏自信之间的关联仍然显著（p < 0.01）。
很大一部分妇女表现出产前综合DAS症状，并且发现多种因素与她们的心理困扰有关。产妇年龄小、丈夫支持度低、收入低、家庭规模大、不良生活事件、缺乏自信、与妊娠相关的担忧和家庭暴力是产前心理状况不佳的更强决定因素。研究结果得出结论，政府层面的政策制定者应启动特别干预计划，以改善社区层面产妇的围产期心理和心理健康。
