【摘要】：目的： 分析孕婦產前焦慮和抑郁狀態(tài)的流行情況,探討各孕期焦慮和抑郁以及整個孕期焦慮和抑郁的變化與孕婦妊娠期體重增加的關系。 方法： 對2011-2013年期間在浙江省某婦幼保健院進行圍產期保健的孕婦,分別在孕12周、孕28周、孕36周進行基線和隨訪調查,用調查問卷收集孕婦社會人口學信息、生殖婚育史和各孕期身體狀況、生活行為信息和焦慮抑郁狀態(tài)的資料。焦慮與抑郁狀態(tài)采用焦慮自評量表(Self Rating Anxiety Scale, SAS)和抑郁自評量表(Self Rating Depression Scale, SDS)評估。并從孕婦的病案收集孕婦的分娩信息和新生兒信息。計算各孕期焦慮、抑郁狀態(tài)流行率,采用多元線性回歸分析各孕期焦慮、抑郁狀態(tài)和變化與各孕期BMI、體重增加的關系,采用多分類多元Logistic回歸模型分析整個孕期焦慮、抑郁變化與孕期增重是否合適的關系。此外,進一步分析產前焦慮和抑郁是否對孕期體重增加存在聯(lián)合作用。 結果： 1.本研究共收集孕早期孕婦2156人,孕中期孕婦1493人,孕晚期孕婦1286人中具有三個孕期完整數(shù)據(jù)的孕婦共969人。孕早、中、晚期焦慮狀態(tài)的流行率分別為14.3%、8.3%和11.7%,抑郁狀態(tài)的流行率分別為50.9%、35.4%和36.0%。孕早、中、晚期SAS、SDS標準總分分別為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,均高于中國常模。 2.孕中期和孕晚期SAS與整個孕期BMI增加呈正相關(β=0.02,P=0.0242；β=0.02,P:=0.0164),孕早期SDS與孕早期BMI增加呈負相關(β=-0.01,P=0.0184)。 3.只發(fā)生孕晚期焦慮、孕中、晚期焦慮、任一孕期焦慮都可能與孕期增重過多的風險相關(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)。孕中期焦慮、孕晚期焦慮、孕中晚期均發(fā)生焦慮、孕中或晚期焦慮都可能與孕期增重過多的風險相關(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)。未觀察到孕期焦慮與孕期增重過少、以及孕期抑郁與孕期體重改變的相關性。 4.產前焦慮和抑郁對孕期增重不存在聯(lián)合作用。 結論： 1.孕期婦女焦慮、抑郁狀態(tài)流行率較高。 2.產前焦慮,尤其是孕中期、孕晚期焦慮可能與孕期增重過多相關。應加強妊娠期的精神保健,促進母嬰健康。
[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 鹵8.47 鹵42.67 鹵7.64 鹵43.41 鹵8.05 and 49.84 鹵9.74 鹵46.21 鹵9.47 鹵46.44 鹵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.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R715.3

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