School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China.
School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China.
J Affect Disord. 2019 Jun 15;253:292-302. doi: 10.1016/j.jad.2019.05.003. Epub 2019 May 2.
Prenatal mental disorders are associated with maternal and fetal adverse outcomes, while few studies have been performed in mainland China. This study aimed to investigate the prevalence and influencing factors of maternal stress, anxiety and depression in early pregnancy and provide scientific basis for reducing prenatal mental disorders.
Data were obtained from 1220 women with < 15 weeks gestation in a cohort study conducted in Chongqing, China. Prenatal stress, anxiety and depression were assessed using the pregnancy pressure scale, the Hamilton anxiety scale, and the self-rating depression scale, respectively.
The prevalence of prenatal stress, anxiety and depression in early pregnancy was 91.86%, 15.04% and 5.19%, respectively. Logistic regression analysis revealed that the risk factors for prenatal stress include housewife/unemployment, presence of anxiety and low- and moderate-level social support, besides, the protective factors were exercise, active smoking and no suggestion from parents. Housewife/unemployment, primiparity, presence of stress and depression and low-level social support were found to be associated with the development of anxiety symptoms, whereas exercise had a protective effect on it. Group-oriented personality, presence of anxiety, no suggestion from husband, low- and moderate-level family care, and low-level social support were risk factors for prenatal depression.
All participants were recruited from one region of China, and none of them have a history of cesarean section.
Early screening and intervention may have great significance for reducing mental disorders of pregnant women, and the family and society support should be brought into the intervention as well.
产前精神障碍与母婴不良结局相关，但中国内地对此研究较少。本研究旨在调查孕早期孕妇应激、焦虑和抑郁的发生率及其影响因素，为降低产前精神障碍提供科学依据。
本队列研究于中国重庆市纳入 1220 例妊娠<15 周的孕妇，采用孕期压力量表、汉密尔顿焦虑量表和自评抑郁量表评估孕妇的产前应激、焦虑和抑郁情况。
孕早期孕妇应激、焦虑和抑郁的发生率分别为 91.86%、15.04%和 5.19%。多因素 Logistic 回归分析显示，产前应激的危险因素包括家庭主妇/失业、存在焦虑和低/中水平的社会支持，保护因素包括运动、主动吸烟和父母无建议；家庭主妇/失业、初产妇、存在应激和抑郁以及低水平社会支持与焦虑症状的发生相关，而运动对其具有保护作用；群体导向型人格、存在焦虑、无丈夫建议、低/中水平家庭关怀和低水平社会支持是产前抑郁的危险因素。
所有参与者均来自中国的一个地区，且均无剖宫产史。
早期筛查和干预可能对降低孕妇精神障碍具有重要意义，应将家庭和社会支持纳入干预措施中。
