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不孕女性在首次接受体外受精/卵胞浆内单精子注射治疗周期中焦虑和抑郁的轨迹和预测因素。

Trajectories and predictors of anxiety and depression amongst infertile women during their first IVF/ICSI treatment cycle.

机构信息

Center for reproductive medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, Shandong 250000, People's Republic of China.

Center for reproductive medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, Shandong 250000, People's Republic of China; Center for reproductive medicine, Shandong provincial hospital affiliated to Shandong University, Jingliu Road, Shizhong District, Jinan, Shandong 250000, People's Republic of China..

出版信息

J Psychosom Res. 2021 Mar;142:110357. doi: 10.1016/j.jpsychores.2021.110357. Epub 2021 Jan 16.

Abstract

PURPOSE

This study aimed to identify anxiety and depression trajectories of infertile women during first IVF treatment cycle and to examine whether the identified trajectories were associated with baseline psychological predictors, namely fertility-related stress, resilience, and illness perception.

METHODS

A longitudinal prospective study was conducted to assess anxiety and depression using the Chinese version of Self-Rating Anxiety Scale (SAS) and Self-Rating depression Scale (SDS) at four different time points: the day of first IVF/ICSI appointment (baseline/T1), the first day of ovarian stimulation (T2), the one day before oocyte retrieval (T3), and the day of fresh embryo transfer (T4). Final analysis was done on data obtained from 202 infertile women. Latent class growth mixed modeling was carried out to identify anxiety and depression trajectories. Multinomial logistic regressions were conducted to investigate predictors of trajectory membership.

RESULTS

Three different adjustment trajectories were identified amongst infertile women during their first IVF/ICSI treatment cycle. A total of 40.1 and 37.6% of women showed normal levels of anxiety and depression (resilient trajectories), respectively, 45.0 and 43.1% of women had recovery trajectories, and 14.9 and 19.3% of women had chronic anxiety and depression trajectories. Non-resilient trajectories were associated with relatively shorter duration of infertility, higher fertility-related stress, and lower resilience.

CONCLUSION

The results imply that it is possible to identify women in chronic or recovery trajectories on the day of first IVF/ICSI appointment, so that tailored prevention strategies integrated components that attenuate stress appraisal and strengthen resilience should be implemented to target those individuals.

摘要

目的

本研究旨在鉴定接受首次体外受精(IVF)治疗的不孕女性的焦虑和抑郁轨迹,并探讨这些轨迹是否与基线心理预测因素(即与生育相关的压力、韧性和疾病认知)有关。

方法

采用前瞻性纵向研究,在四个不同时间点(首次 IVF/ICSI 预约日(基线/T1)、卵巢刺激的第一天(T2)、取卵前一天(T3)和新鲜胚胎移植日(T4))使用中文版焦虑自评量表(SAS)和抑郁自评量表(SDS)评估焦虑和抑郁。最终分析了 202 名不孕女性的数据。采用潜在类别增长混合模型鉴定焦虑和抑郁轨迹,采用多项逻辑回归分析轨迹成员的预测因素。

结果

在首次 IVF/ICSI 治疗周期中,不孕女性存在三种不同的调整轨迹。分别有 40.1%和 37.6%的女性表现出正常的焦虑和抑郁水平(韧性轨迹),45.0%和 43.1%的女性表现出恢复轨迹,14.9%和 19.3%的女性表现出慢性焦虑和抑郁轨迹。非韧性轨迹与不孕持续时间较短、与生育相关的压力较高以及韧性较低有关。

结论

这些结果表明,在首次 IVF/ICSI 预约日有可能鉴定出处于慢性或恢复轨迹的女性,以便实施针对这些个体的、以减轻压力评估和增强韧性为目标的、有针对性的预防策略。

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