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背景:高危孕妇与普通孕妇相比在妊娠期会出现更多的并发症,高危因素作为一种应激因素更易诱发孕妇产生焦虑、抑郁等负面情绪症状。目前国内外对高危孕妇焦虑、抑郁症状的研究相对较少。目标:调查产科高危妊娠孕妇焦虑、抑郁症状发生率及其相关危险因素。方法:对197例孕中期(16-20周)的高危孕妇在妊娠最后4月每月进行综合性医院焦虑/抑郁量表(HAD)评估和风险因素调查。产后3-7天、42天及3月进行爱丁堡产后抑郁量表(EPDS)评估和风险因素调查。结果:入组时高危孕妇HAD焦虑均分:3.69(2.76),抑郁均分:3.42(2.53)。焦虑症状14例(7.18%),抑郁症状10例(5.13%)。多因素分析显示,怀孕有无保胎(OR:8.162,95%CI:1.213-54.914)和乙肝阳性(OR:8.912,95%CI:1.052-75.498)与焦虑症状相关。尿糖阳性(OR:30.529,95%CI:1.312-710.610)和既往出血史(OR:7.122,95%CI:1.015-49.984)与抑郁症状相关。孕期影响高危孕妇焦虑、抑郁症状的因素有:近3月孕妇健康状况、担心胎儿健康、夫妻关系、婆媳关系等。结论:高危妊娠孕妇焦虑、抑郁症状较常见。近3月孕妇健康状况、婆媳关系、夫妻关系、担心胎儿健康是高危孕妇孕期焦虑、抑郁症状的风险因素。
Background: Compared with ordinary pregnant women, high-risk pregnant women will have more complications during pregnancy. High-risk factors as a stress factor may induce negative emotional symptoms such as anxiety and depression in pregnant women. At present, the researches on anxiety and depression in high-risk pregnant women are relatively few at home and abroad. OBJECTIVE: To investigate the incidence of anxiety and depressive symptoms in pregnant women with obstetric and at-risk pregnancies and related risk factors. METHODS: Ninety-seven high-risk pregnant women of the second trimester (16-20 weeks) were assessed monthly for comprehensive hospital anxiety / depression scale (HAD) and risk factors in the last trimester of pregnancy. Postpartum 3-7 days, 42 days, and March assessments of Edinburgh Postpartum Depression Scale (EPDS) and risk factors were performed. Results: HAD anxiety in high-risk pregnant women at enrollment was 3.69 (2.76) and depression was 3.42 (2.53). Anxiety symptoms in 14 cases (7.18%), depression symptoms in 10 cases (5.13%). Multivariate analysis showed that pregnancy with or without miscarriage (OR: 8.162, 95% CI: 1.213-54.914) and hepatitis B positive (OR: 8.912, 95% CI: 1.052-75.498) were associated with anxiety symptoms. Urine positive (OR: 30.529, 95% CI: 1.312-710.610) and previous history of bleeding (OR: 7.122, 95% CI: 1.015-49.984) were associated with depressive symptoms. Pregnant women at high risk of anxiety, depression symptoms are: nearly 3 months of pregnant women, worried about fetal health, marital relations, law-abiding and so on. Conclusion: Anxiety and depressive symptoms are more common in high-risk pregnant women. Nearly three months pregnant women’s health status, mother-daughter relationship, husband and wife relationship, worried about fetal health risk factors for high-risk pregnant women during pregnancy anxiety and depression symptoms.