孕产妇产前焦虑和抑郁与妊娠期体重增加的关系

发布时间：2018-11-02 18:41

【摘要】：目的：分析孕妇产前焦虑和抑郁状态的流行情况,探讨各孕期焦虑和抑郁以及整个孕期焦虑和抑郁的变化与孕妇妊娠期体重增加的关系。方法：对2011-2013年期间在浙江省某妇幼保健院进行围产期保健的孕妇,分别在孕12周、孕28周、孕36周进行基线和随访调查,用调查问卷收集孕妇社会人口学信息、生殖婚育史和各孕期身体状况、生活行为信息和焦虑抑郁状态的资料。焦虑与抑郁状态采用焦虑自评量表(Self Rating Anxiety Scale, SAS)和抑郁自评量表(Self Rating Depression Scale, SDS)评估。并从孕妇的病案收集孕妇的分娩信息和新生儿信息。计算各孕期焦虑、抑郁状态流行率,采用多元线性回归分析各孕期焦虑、抑郁状态和变化与各孕期BMI、体重增加的关系,采用多分类多元Logistic回归模型分析整个孕期焦虑、抑郁变化与孕期增重是否合适的关系。此外,进一步分析产前焦虑和抑郁是否对孕期体重增加存在联合作用。结果： 1.本研究共收集孕早期孕妇2156人,孕中期孕妇1493人,孕晚期孕妇1286人中具有三个孕期完整数据的孕妇共969人。孕早、中、晚期焦虑状态的流行率分别为14.3%、8.3%和11.7%,抑郁状态的流行率分别为50.9%、35.4%和36.0%。孕早、中、晚期SAS、SDS标准总分分别为44.33±8.47、42.67±7.64、43.41±8.05和49.84±9.74、46.21±9.47、46.44±9.89,均高于中国常模。 2.孕中期和孕晚期SAS与整个孕期BMI增加呈正相关(β=0.02,P=0.0242；β=0.02,P:=0.0164),孕早期SDS与孕早期BMI增加呈负相关(β=-0.01,P=0.0184)。 3.只发生孕晚期焦虑、孕中、晚期焦虑、任一孕期焦虑都可能与孕期增重过多的风险相关(OR=2.32,95%CI,1.15-4.69；OR=4.55,95%CI,1.30-16.02；OR=1.73,95%CI,1.19-2.53)。孕中期焦虑、孕晚期焦虑、孕中晚期均发生焦虑、孕中或晚期焦虑都可能与孕期增重过多的风险相关(OR=2.40,95%CI,1.13-5.08;OR=2.03,95%CI,1.24-3.32；OR=2.00,95%CI,1.09-3.65；OR=91,95%CI,1.22-3.00)。未观察到孕期焦虑与孕期增重过少、以及孕期抑郁与孕期体重改变的相关性。 4.产前焦虑和抑郁对孕期增重不存在联合作用。结论： 1.孕期妇女焦虑、抑郁状态流行率较高。 2.产前焦虑,尤其是孕中期、孕晚期焦虑可能与孕期增重过多相关。应加强妊娠期的精神保健,促进母婴健康。
[Abstract]:Objective: to analyze the prevalence of prenatal anxiety and depression in pregnant women, and to explore the relationship between the changes of anxiety and depression during pregnancy and the weight gain during pregnancy. Methods: during 2011-2013, the pregnant women who received perinatal care in a maternal and child health care hospital in Zhejiang Province were investigated at baseline and follow up at 12 weeks, 28 weeks and 36 weeks of pregnancy, respectively. The social demographic information of pregnant women was collected by questionnaire. Reproductive and childbearing history, physical status, life behavior information and anxiety and depression data. Anxiety and depression were assessed by self-rating anxiety scale (Self Rating Anxiety Scale, SAS) and self-rating Depression scale (Self Rating Depression Scale, SDS). Maternal delivery information and neonatal information were collected from the medical records of pregnant women. The prevalence rate of anxiety and depression in each pregnancy was calculated, and the relationship between anxiety, depression and changes during pregnancy and the weight gain of BMI, during pregnancy were analyzed by multiple linear regression analysis. The anxiety during pregnancy was analyzed by multi-classification multiple Logistic regression model. The relationship between depression and weight gain during pregnancy. In addition, the combined effect of prenatal anxiety and depression on weight gain during pregnancy was further analyzed. Results: 1. In this study, there were 2156 pregnant women in early pregnancy, 1493 in second trimester, and 969 in 1286 pregnant women in the third trimester. The prevalence rates of anxiety in the first trimester, middle and late pregnancy were 14.3% and 11.7%, respectively, and the prevalence rates of depression were 50.935. 4% and 36. 0%, respectively. The total scores of SAS,SDS were 44.33 卤8.47 卤42.67 卤7.64 卤43.41 卤8.05 and 49.84 卤9.74 卤46.21 卤9.47 卤46.44 卤9.89, respectively, which were higher than the Chinese norm. 2. There was a positive correlation between the increase of BMI in the second trimester and the third trimester of pregnancy (尾 = 0.02P = 0.0242; 尾 = 0.02P: P: 0.0164), and a negative correlation between SDS and the increase of BMI in the first trimester of pregnancy (尾 = -0.01). 3. Anxiety only occurs in the third trimester. Anxiety in the third trimester of pregnancy and anxiety in any pregnancy may be associated with the risk of excess weight gain during pregnancy (OR=2.32,95%CI,1.15-4.69;OR=4.55,95%CI,1.30-16.02; OR=1.73,95%CI,1.19-2.53) Anxiety in the second trimester, anxiety in the third trimester, anxiety in the second trimester, and anxiety in the second trimester may be associated with the risk of excess weight gain during pregnancy (OR=2.40,95%CI,1.13-5.08;OR=2.03,95%CI,1.24-3.32;). OR=2.00,95%CI,1.09-3.65;OR=91,95%CI,1.22-3.00) There was no correlation between anxiety and weight gain during pregnancy, and between depression and weight change during pregnancy. 4. Prenatal anxiety and depression had no combined effect on weight gain during pregnancy. Conclusion: 1. The prevalence of anxiety and depression was higher in pregnant women. 2. Prenatal anxiety, especially in the second trimester, may be associated with excess weight gain during pregnancy. Mental health care during pregnancy should be strengthened to promote maternal and child health.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R715.3

【相似文献】