Herath I N S, Balasuriya A, Sivayogan S
a Ministry of Health , Sri Lanka.
b Faculty of Medicine , General Sir John Kotelawala Defence University , Ratmalana , Sri Lanka.
J Obstet Gynaecol. 2017 Oct;37(7):849-854. doi: 10.1080/01443615.2017.1306697. Epub 2017 Apr 11.
While motherhood is often a positive and satisfying experience, for some women, it is linked with suffering and ill-health. A woman should be able to feel physically and mentally content during pregnancy. Discomforts in pregnancy may be considered as insignificant by the physician. Therefore, the objective of this study was to determine physical and psychological morbidities among primigravid antenatal females in the Kegalle District, Sri Lanka. A sample of 1017 second and third trimester primigravid antenatal females selected by a two-stage probability proportional to size cluster sampling method, were assessed for physical and psychological problems. Data analysis was done using SPSS 16 package and associations were found using Chi square test with p values. The presence of any physical health problem during the preceding 14 days was reported by 75.7% (95% CI 73.0-78.2) of females though each individual physical problem was reported by less than or around one-third. Prevalence of psychological distress and depression was 22.7% (95% CI 20.2-25.4) and 10.4% (95% CI 8.7-12.4), respectively. The self-rated health was very good in 24.7% and good in 55.9%. Older employed females had significantly higher physical problems. It is concluded that although the self-rated wellbeing during pregnancy is high, the presence of physical and psychological ill-health is substantial. Impact statement Pregnancy is a time of intense physical change and is associated with emotional upheaval in many women. Obstetric morbidity is defined as morbidity in a woman who has been pregnant regardless of the site or the duration of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. It is classified into three categories namely; direct, indirect and psychological obstetric morbidity. For one maternal death, there can be between 9 and 16 females with obstetric morbidity depending on the level of development of a country. As a country with good health indicators, this study was conducted to determine physical and psychological problems among primigravid antenatal females in the Kegalle District,p Sri Lanka to improve service quality further. The presence of any physical health problem during the preceding 14 days was reported by a quarter of females and backache, fatigue, body aches, psychological distress, urinary incontinence and headache was commonly reported individual problems. Older employed females had significantly higher physical problems. Though trivial for health workers, physical and psychological problems are prevalent. These should be actively sought and remedied by health workers to improve the quality of life.
虽然为人母通常是一段积极且令人满足的经历,但对一些女性来说,它却与痛苦和健康不佳有关。女性在孕期应能在身心方面感到满足。孕期的不适在医生看来可能微不足道。因此,本研究的目的是确定斯里兰卡凯格勒地区初产妇产前女性的身体和心理疾病情况。通过两阶段按规模大小概率比例整群抽样方法选取了1017名孕中期和孕晚期的初产妇产前女性样本,对其身体和心理问题进行了评估。使用SPSS 16软件包进行数据分析,并通过卡方检验及p值来发现关联。75.7%(95%可信区间73.0 - 78.2)的女性报告在之前14天内存在任何身体健康问题,不过每种具体身体问题的报告比例均不到或约为三分之一。心理困扰和抑郁的患病率分别为22.7%(95%可信区间20.2 - 25.4)和10.4%(95%可信区间8.7 - 12.4)。自我评定健康状况为“非常好”的占24.7%,“好”的占55.9%。年龄较大的在职女性身体问题显著更多。研究得出结论,尽管孕期自我评定的幸福感较高,但身体和心理方面的健康不佳情况依然很严重。影响声明孕期是身体剧烈变化的时期,且在许多女性中与情绪波动有关。产科发病率被定义为曾怀孕女性无论怀孕部位或时长,因与怀孕或其处理相关或由其加重的任何原因(而非意外或偶然原因)导致的发病情况。它分为三类,即直接产科发病率、间接产科发病率和心理产科发病率。根据一个国家的发展水平,每有1例孕产妇死亡,就可能有9至16名女性患有产科疾病。作为一个健康指标良好的国家,开展本研究是为了确定斯里兰卡凯格勒地区初产妇产前女性的身体和心理问题,以进一步提高服务质量。四分之一的女性报告在之前14天内存在任何身体健康问题,背痛、疲劳、身体疼痛、心理困扰、尿失禁和头痛是常见的具体问题。年龄较大的在职女性身体问题显著更多。尽管对医护人员来说这些问题看似微不足道,但身体和心理问题却很普遍。医护人员应积极寻找并解决这些问题,以提高生活质量。