Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China; Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France.
The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders & Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China; School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
J Affect Disord. 2020 Mar 1;264:187-192. doi: 10.1016/j.jad.2019.12.011. Epub 2019 Dec 11.
Poor mental health status among both pregnant and postpartum women is commonly reported worldwide. The associations between mental health outcomes and giving birth to the second child since the implementation of China's universal two-child policy have not been identified.
A large-scale based mental health survey was conducted between March 2017 and December 2018 in Suzhou, China. The survey evaluated the symptoms of anxiety, hypomania, depression and poor sleep quality among both pregnant and postpartum women.
A total of 3113 questionnaires were collected, the prevalence of anxiety, hypomanic and depressive symptoms and poor sleep quality in our sample were 3.2% (95%CI: 2.6%-3.9%), 51.7% (95%CI: 49.9%-53.4%), 12.4% (95%CI: 11.3%-13.6%) and 37.8% (95%CI: 36.0%-39.5%), respectively. Logistic regression showed that giving birth to the second child was positively associated with women's age, and was negatively correlated with higher educational level and living in rented housing. Women with the second pregnancy or child were positively associated with anxiety symptoms in the whole sample (OR = 1.75, 95%CI: 1.11-2.75) and among prenatal women (OR = 2.11, 95%CI: 1.16-3.83), while it was inversely correlated with depressive symptoms among postpartum women (OR = 0.63, 95%CI: 0.41-0.99).
Women giving birth a second time were more prone to have anxiety symptoms among the prenatal women and the whole sample, and less likely to have depressive symptoms among the postpartum women. Efficacious measures and interventions are essential to improve maternal mental health.
全球范围内，孕妇和产后女性的心理健康状况较差是常见现象。自中国实施普遍二孩政策以来，心理健康结果与生育二孩之间的关系尚未确定。
2017 年 3 月至 2018 年 12 月在中国苏州进行了一项大规模心理健康调查。该调查评估了孕妇和产后女性的焦虑、轻躁狂、抑郁和睡眠质量差的症状。
共收集了 3113 份问卷，我们的样本中焦虑、轻躁狂、抑郁和睡眠质量差的患病率分别为 3.2%（95%CI：2.6%-3.9%）、51.7%（95%CI：49.9%-53.4%）、12.4%（95%CI：11.3%-13.6%）和 37.8%（95%CI：36.0%-39.5%）。Logistic 回归显示，生育二孩与女性年龄呈正相关，与较高的教育水平和租房居住呈负相关。在整个样本中（OR=1.75，95%CI：1.11-2.75）和产前女性中（OR=2.11，95%CI：1.16-3.83），有第二胎或孩子的女性与焦虑症状呈正相关，而与产后女性的抑郁症状呈负相关（OR=0.63，95%CI：0.41-0.99）。
再次生育的女性在产前女性和整个样本中更容易出现焦虑症状，而在产后女性中出现抑郁症状的可能性较低。需要采取有效的措施和干预措施来改善产妇的心理健康。
