中国农村地区的围产期心理健康问题：社会因素的作用
Perinatal Mental Health Problems in Rural China: The Role of Social Factors.
作者信息
Jiang Qi, Guo Yian, Zhang Evelyn, Cohen Nourya, Ohtori Mika, Sun Adrian, Dill Sarah-Eve, Singh Manpreet Kaur, She Xinshu, Medina Alexis, Rozelle Scott D
机构信息
Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States.
Stanford Pediatric Mood Disorders Program, Stanford University, Stanford, CA, United States.
出版信息
Front Psychiatry. 2021 Dec 7;12:636875. doi: 10.3389/fpsyt.2021.636875. eCollection 2021.
Perinatal mental health is important for the well-being of the mother and child, so the relatively high prevalence of perinatal mental health problems in developing settings poses a pressing concern. However, most studies in these settings focus on the demographic factors associated with mental health problems, with very few examing social factors. Hence, this study examines the prevalence of the depressive, anxiety and stress symptoms among pregnant women and new mothers in rural China, and the associations between these mental health problems and social factors, including decision-making power, family conflicts, and social support. Cross-sectional data were collected from 1,027 women in their second trimester of pregnancy to 6 months postpartum in four low-income rural counties in Sichuan Province, China. Women were surveyed on symptoms of mental health problems using the Depression, Anxiety, and Stress Scale (DASS-21) and social risk factors. Multivariate logistic regression analyses were conducted to examine social risk factors associated with maternal mental health problems, with results reported as odds ratios (OR) and 95% confidence intervals (CI). Among all respondents, 13% showed symptoms of depression, 18% showed symptoms of anxiety, 9% showed symptoms of stress, and 23% showed symptoms of any mental health problem. Decision-making power was negatively associated with showing symptoms of depression (OR = 0.71, CI: 0.60-0.83, < 0.001) and stress (OR = 0.76, CI: 0.63-0.90, = 0.002). Family conflict was positively associated with depression (OR = 1.53, CI: 1.30-1.81, < 0.001), anxiety (OR = 1.34, CI: 1.15-1.56, < 0.001), and stress (OR = 1.68, CI: 1.41-2.00, < 0.001). In addition, social support was negatively associated with depression (OR = 0.56, CI: 0.46-0.69, < 0.001), anxiety (OR = 0.76, CI: 0.63-0.91, = 0.002), and stress (OR = 0.66, CI: 0.53-0.84, < 0.001). Subgroup analyses revealed that more social risk factors were associated with symptoms of anxiety and stress among new mothers compared to pregnant women. Perinatal mental health problems are relatively prevalent among rural women in China and are strongly associated with social risk factors. Policies and programs should therefore promote individual coping methods, as well as target family and community members to improve the social conditions contributing to mental health problems among rural women.
围产期心理健康对母婴的幸福至关重要，因此在发展中地区围产期心理健康问题相对较高的患病率令人深感担忧。然而，这些地区的大多数研究都集中在与心理健康问题相关的人口统计学因素上，很少有研究考察社会因素。因此，本研究调查了中国农村孕妇和新妈妈中抑郁、焦虑和压力症状的患病率，以及这些心理健康问题与社会因素之间的关联，包括决策权、家庭冲突和社会支持。在中国四川省四个低收入农村县，收集了1027名处于孕中期至产后6个月的妇女的横断面数据。使用抑郁、焦虑和压力量表（DASS - 21）及社会风险因素对妇女进行心理健康问题症状调查。进行多变量逻辑回归分析以检验与孕产妇心理健康问题相关的社会风险因素，结果以比值比（OR）和95%置信区间（CI）报告。在所有受访者中，13%有抑郁症状，18%有焦虑症状，9%有压力症状，23%有任何心理健康问题症状。决策权与出现抑郁症状（OR = 0.71，CI：0.60 - 0.83，< 0.001）和压力症状（OR = 0.76，CI：0.63 - 0.90，= 0.002）呈负相关。家庭冲突与抑郁（OR = 1.53，CI：1.30 - 1.81，< 0.001）、焦虑（OR = 1.34，CI：1.15 - 1.56，< 0.001）和压力（OR = 1.68，CI：1.41 - 2.00，< 0.001）呈正相关。此外，社会支持与抑郁（OR = 0.56，CI：0.46 - 0.69，< 0.001）、焦虑（OR = 0.76，CI：0.63 - 0.91，= 0.002）和压力（OR = 0.66，CI：0.53 - 0.84，< 0.001）呈负相关。亚组分析显示，与孕妇相比，新妈妈中有更多社会风险因素与焦虑和压力症状相关。围产期心理健康问题在中国农村妇女中相对普遍，且与社会风险因素密切相关。因此，政策和项目应促进个体应对方法，同时针对家庭和社区成员改善导致农村妇女心理健康问题的社会状况。
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