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[居家护理管理中孕妇焦虑和抑郁的评估]

[Assesment of anxiety and depression in pregnant women in home care management].

作者信息

Malandain Anais, Barrois Mathilde

机构信息

Assistance publique-Hôpitaux de Paris (AP-HP), Paris Public Hospital at Home (HAD AP-HP), Greater Paris University Hospitals, Paris, France.

Assistance publique-Hôpitaux de Paris (AP-HP), Paris Public Hospital at Home (HAD AP-HP), Greater Paris University Hospitals, Paris, France; Department of Obstetrics and Gynecology, Assistance publique-Hôpitaux de Paris, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel-Dieu, Paris, France.

出版信息

Gynecol Obstet Fertil Senol. 2025 Apr;53(4):167-172. doi: 10.1016/j.gofs.2024.12.002. Epub 2024 Dec 9.

Abstract

OBJECTIVE

This study aims to identify factors associated with depressive and anxious symptomatology in pregnant women hospitalized during the antepartum period in home care management (Hospitalisation à domicile).

METHOD

This is a quantitative, single-center, observational, and descriptive study that included all French-speaking women hospitalized in the HAD of AP-HP between September 2022 and February 2023. Anxious and depressive symptoms were assessed using the self-administered HADS (Hospital Anxiety and Depression Scale) questionnaire. Analyses were conducted according to two distinct groups, comparing patients with an anxiety or depression scores below 8 on the HADS to those with a score of 8 or above (the threshold set on the questionnaire corresponding to intermediate symptomatology). A second questionnaire created for the study detailed maternal history, pregnancy experience, and lifestyle.

RESULTS

A total of sixty-four women were included from September 20, 2022, to February 15, 2023. Eighteen women (28%) evaluated had anxious symptomatology and thirteen women (20%) had depressive symptomatology. Factors significantly associated with anxiety were poor pregnancy experience (P=0.04), the need for psychological follow-up during pregnancy (P<0.01), country of birth (P=0.022), as well as psychiatric history such as previous consultations with a mental health specialist (P=0.015) and previous psychotropic treatment (P=0.028). Additionally, a history of violence (respectively, P=0.034 and P<0.01) and the women's belief that a consultation with a psychologist would benefit them were also associated with anxious and depressive symptomatology (respectively, P<0.01 and P<0.01) CONCLUSION: Our results highlight the importance and necessity of enhancing the screening and prevention of various mental disorders during pregnancy. It would be interesting to implement organized screening for anxiety, similar to depression, in pregnant women hospitalized at home and for the entire obstetric population.

摘要

目的

本研究旨在确定在家庭护理管理(居家住院)的产前期间住院的孕妇中,与抑郁和焦虑症状相关的因素。

方法

这是一项定量、单中心、观察性和描述性研究,纳入了2022年9月至2023年2月期间在巴黎公立医院集团居家住院部住院的所有说法语的女性。使用自我管理的医院焦虑抑郁量表(HADS)问卷评估焦虑和抑郁症状。根据两个不同的组进行分析,将HADS焦虑或抑郁评分低于8分的患者与评分在8分及以上的患者(问卷设定的阈值对应中度症状)进行比较。为该研究创建的第二份问卷详细记录了产妇病史、妊娠经历和生活方式。

结果

从2022年9月20日至2023年2月15日,共纳入64名女性。评估的18名女性(28%)有焦虑症状,13名女性(20%)有抑郁症状。与焦虑显著相关的因素包括妊娠经历不佳(P = 0.04)、孕期需要心理随访(P < 0.01)、出生国家(P = 0.022),以及精神病史,如之前咨询过心理健康专家(P = 0.015)和之前接受过精神药物治疗(P = 0.028)。此外,暴力史(分别为P = 0.034和P < 0.01)以及女性认为咨询心理医生会对她们有益的信念也与焦虑和抑郁症状相关(分别为P < 0.01和P < 0.01)。结论:我们的结果强调了加强孕期各种精神障碍筛查和预防的重要性和必要性。对居家住院的孕妇以及整个产科人群实施类似抑郁症的焦虑症有组织筛查将是很有意义的。

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