Shen Qiaoqiao, Luo Xiangping, Wei Meijuan, Chen Bizhen
School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
J Adv Nurs. 2025 Apr;81(4):1875-1883. doi: 10.1111/jan.16378. Epub 2024 Aug 6.
To determine the longitudinal trajectories of anxiety and depression among pregnant women who have experienced pregnancy loss, and to explore the association between post-traumatic stress symptoms (PTSS) related to pregnancy loss and these trajectories.
A prospective longitudinal study.
Between October 2022 and August 2023, pregnant women with a history of pregnancy loss were recruited from four hospitals in Guangdong Province, China. Eligible participants were screened for PTSS related to pregnancy loss upon enrolment. Anxiety and depression symptoms were assessed in early, mid and late pregnancy using the Pregnancy-related Anxiety Questionnaire-Revised 2 and the Patient Health Questionnaire-9, respectively. Latent class growth analysis was employed to categorize anxiety and depression trajectories, and multinomial logistic regression analysis was conducted to examine the association between PTSS and these trajectories.
Of the 388 participants included in the analysis, 158 individuals (40.7%) reported high PTSS scores. The best-fitting models identified three trajectories for both anxiety and depression: low (anxiety: 35.6%, depression: 48.7%), moderate (anxiety: 44.8%, depression: 40.5%) and high (anxiety: 19.6%, depression: 10.8%). Pregnant women with high PTSS levels were significantly more likely to experience moderate-to-high trajectories of anxiety and depression compared to those with low PTSS levels.
Pregnant women who have experienced pregnancy loss exhibit higher incidences of elevated anxiety and depression trajectories. Screening for PTSS and targeted supportive care are recommended to alleviate anxiety and depressive symptoms in this population.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study underscores the importance of early psychological screening and tailored interventions for pregnant women with a history of pregnancy loss. Trauma-informed care should be prioritized to mitigate anxiety and depression trajectories in this vulnerable population.
There was no patient or public involvement.
确定经历过流产的孕妇焦虑和抑郁的纵向轨迹，并探讨与流产相关的创伤后应激症状（PTSS）与这些轨迹之间的关联。
一项前瞻性纵向研究。
2022年10月至2023年8月期间，从中国广东省的四家医院招募有流产史的孕妇。符合条件的参与者在入组时接受与流产相关的PTSS筛查。分别在孕早期、中期和晚期使用修订版妊娠相关焦虑问卷2和患者健康问卷9评估焦虑和抑郁症状。采用潜在类别增长分析对焦虑和抑郁轨迹进行分类，并进行多项逻辑回归分析以检验PTSS与这些轨迹之间的关联。
纳入分析的388名参与者中，158人（40.7%）报告PTSS得分高。最佳拟合模型确定焦虑和抑郁均有三种轨迹：低（焦虑：35.6%，抑郁：48.7%）、中（焦虑：44.8%，抑郁：40.5%）和高（焦虑：19.6%，抑郁：10.8%）。与PTSS水平低的孕妇相比，PTSS水平高的孕妇经历中度至高度焦虑和抑郁轨迹的可能性显著更高。
经历过流产的孕妇焦虑和抑郁轨迹升高的发生率更高。建议对PTSS进行筛查并提供有针对性的支持性护理，以减轻该人群的焦虑和抑郁症状。
对专业和/或患者护理的启示：本研究强调了对有流产史的孕妇进行早期心理筛查和量身定制干预措施的重要性。应优先考虑创伤知情护理，以减轻这一弱势群体的焦虑和抑郁轨迹。
没有患者或公众参与。
