孕产妇妊娠不同时期抑郁症状及其影响因素分析

摘要

目的 探讨妊娠不同时期产前抑郁发病状况及其影响因素. 方法 采用方便抽样方法,于2015年12月-2016年5月在广东省某三甲医院产科门诊抽取妊娠不同时期产检孕妇共1 899名为调查对象,采用一般资料调查表,爱丁堡产后抑郁量表(EPDS)进行问卷调查,分析孕妇出现的产前抑郁状况及其影响因素. 结果 1 899名孕妇中,存在产前抑郁症状的638人,抑郁症状总发生率为33.6％,孕早、中、晚期的抑郁症状发生率分别为34.3％、31.1％、36.8％,不同孕期抑郁发生率比较,差异无统计学意义.经Logistic回归分析发现,孕妇产前抑郁症状的危险因素为孕期无工作(OR=1.6,95％ CI:1.1 ～2.4)、有流产史(OR=1.3,95％ CI:1.0 ～ 1.8)、有产前抑郁史(0R=3.9,95％ CI:1.4～10.7)、夫妻关系不和谐(OR =4.4,95％ CI:1.8～10.4)、对胎儿性别期待(OR=2.3,95％ CI:1.5 ～3.4). 结论 三甲医院孕产妇抑郁症状在妊娠不同时期发生率高,而产前抑郁成为孕产妇常见的心理问题,妊娠期间无工作、有流产史、有产前抑郁史、夫妻普通、对胎儿有性别期待是其发生的危险因素.%Objective To obtain prevalence of maternal antenatal depression disorders during different period of pregnancy and to explore associated factors.Methods A total of 1899 pregnant women who received health care in the hospital during December 2015 and May 2016 were included.A questionnaire was used to collect social and psychological data.Depression was assessed using the Edinburgh Postnatal Depression Scale (Edinburgh Postnatal Depression Scale,EPDS).Results Of 1899 women,638 (33.6％) had antenatal depression symptoms,resulting in a prevalence of 34.3％,31.1％,and 34.3％,respectively,in the three trimesters.Logistic regression analysis showed that antenatal depression was associated with not working (OR =1.6,95％ CI:1.1-2.4),abortion history (OR =1.3,95％ CI:1.0-1.8),antenatal depression history (OR =3.9,95％ CI:1.4-10.7),non-harmonious relationship with partner (OR =4.4,95％ CI:1.8-10.4),and gender expectation (OR =2.3,95％ CI:1.5-3.4).Conclusion Several risk factors were identified for prenatal depression.Antenatal care may incorporate these factors to reduce the risk.