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有并发症病史的孕妇中与显著焦虑和抑郁症状相关的因素。

Factors Associated with Significant Anxiety and Depressive Symptoms in Pregnant Women with a History of Complications.

作者信息

Chen Jing, Cai Yiyun, Liu Yue, Qian Jieyan, Ling Qing, Zhang Wei, Luo Jianfeng, Chen Yan, Shi Shenxun

机构信息

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Psychiatry, Huashan Hospital of Fudan University, Shanghai, China.

出版信息

Shanghai Arch Psychiatry. 2016 Oct 25;28(5):253-262. doi: 10.11919/j.issn.1002-0829.216035.

Abstract

BACKGROUND

The occurrence of complications during the gestation period is higher among pregnant women with a history of complications than among pregnant women without previous complications. High-risk pregnancy can cause negative emotional symptoms such as anxiety and depression in pregnant women. Current research on anxiety and depression symptoms in pregnant women is sparse.

AIMS

To examine the incidence of anxiety and depression symptoms in pregnant women with a history of previous complications or high risk pregnancy and related risk factors.

METHODS

Women with a history of previous complications in pregnancy or current 'high risk' pregnancy (e.g. test tube fertilization, etc.) were classified as 'high risk'. 197 of these 'high risk' women who were in their second trimester (16 to 20 weeks) underwent a monthly comprehensive assessment using the Hospital Anxiety and Depression Scale (HAD) in the last 4 months of the gestation period. The Edinburgh Postnatal Depression Scale (EPDS) was used for assessment and risk factor investigation 3 to 7 days, 42 days, and 3 months after childbirth.

RESULTS

The mean (sd) HAD anxiety score among 'high-risk'women at the time of enrollment was 3.69 (2.76) and depression score was 3.42 (2.53). Significant anxiety symptoms and depression symptoms were found in 14 cases (7.18 %) and 10 cases (5.13%), respectively. Multivariate analysis showed a correlation between anxiety symptoms and history of miscarriage (OR: 8.162, 95%CI: 1.213 to 54.914)and testing positive for hepatitis (OR: 8.912, 95%CI: 1.052 to 75.498). Depressive symptoms were correlated with glucose positive urine (OR: 30.529, 95%CI: 1.312 to 710.610) and history of hemorrhaging (OR: 7.122, 95%CI: 1.015 to 49.984). General factors associated with anxiety and depression symptoms include patients' health status in the recent 3 months, concerns about fetal health, quality of marital relationship, and relationship with in-laws.

CONCLUSIONS

Anxiety and depression symptoms are commonly seen in pregnant women with a history of previous complications or current 'high risk' pregnancy. Patients' recent health status, relationship with in-laws, marital quality and concerns about fetal health are associated with anxiety and depression symptoms during pregnancy.

摘要

背景

有并发症病史的孕妇孕期并发症的发生率高于无既往并发症的孕妇。高危妊娠可导致孕妇出现焦虑和抑郁等负面情绪症状。目前关于孕妇焦虑和抑郁症状的研究较少。

目的

探讨有既往并发症病史或高危妊娠的孕妇焦虑和抑郁症状的发生率及相关危险因素。

方法

有既往妊娠并发症病史或当前“高危”妊娠(如试管婴儿等)的女性被归类为“高危”。其中197名处于孕中期(16至20周)的“高危”女性在妊娠期的最后4个月每月使用医院焦虑抑郁量表(HAD)进行一次综合评估。产后3至7天、42天和3个月时使用爱丁堡产后抑郁量表(EPDS)进行评估和危险因素调查。

结果

“高危”女性入组时HAD焦虑量表的平均(标准差)得分为3.69(2.76),抑郁量表得分为3.42(2.53)。分别有14例(7.18%)和10例(5.13%)出现明显的焦虑症状和抑郁症状。多因素分析显示,焦虑症状与流产史(比值比:8.162,95%置信区间:1.213至54.914)及肝炎检测呈阳性(比值比:8.912,95%置信区间:1.052至75.498)相关。抑郁症状与尿糖阳性(比值比:30.529,95%置信区间:1.312至710.610)及出血史(比值比:7.122,95%置信区间:1.015至49.984)相关。与焦虑和抑郁症状相关的一般因素包括患者近3个月的健康状况、对胎儿健康的担忧、婚姻关系质量以及与公婆的关系。

结论

有既往并发症病史或当前“高危”妊娠的孕妇中常见焦虑和抑郁症状。患者近期的健康状况、与公婆的关系、婚姻质量以及对胎儿健康的担忧与孕期焦虑和抑郁症状相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/752f/5434281/70193495efad/sap-28-253-g001.jpg

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