孕中晚期心理及其对产后应激状况影响研究

目的了解北京西城区助产机构孕妇孕期心理状况及对产后应激状况的影响。方法应用症状自评量表(SCL-90)和应激评估量表平时版(PCL-C),对西城区助产机构产科973名孕妇进行抽样测试研究。结果①除躯体化因子,其他各因子不同孕期孕妇SCL-90评分均低于全国常模(P<0.05);②不同户籍孕妇SCL-90评分低于全国常模(P<0.05),北京农村户籍孕妇的抑郁、焦虑、敌对、恐怖与常模相比差异不具有统计学意义(P>0.05);③产后42天产妇创伤后应激障碍筛查阳性率为1.13%;④通过相关分析,孕晚期心理和产后应激水平呈正相关(P<0.05)。结论西城区孕妇孕期总体心理状况较好,产后应激水平也较低;孕晚期心理状况不良的孕妇容易在产后发生应激障碍。     

心理干预对伴发抑郁症状的围生期孕妇生活质量的影响

目的:探讨心理干预对伴有抑郁症状的围生期孕妇抑郁状况及生活质量的影响.方法:将符合入组条件的60例第一胎围生期孕妇随机分为心理干预组30例,对照组30例,对心理干预组于妊娠30周时开始实施不少于7周的连续心理干预,包括支持性心理治疗、健康教育、个别深入的心理治疗、家庭和社会支持治疗等;对照组无特殊干预措施.两组均于妊娠30周、38周时进行两次抑郁自评量表及生活质量量表的测验.结果:妊娠38周时心理干预组孕妇的抑郁因子较对照组抑郁因子分低(P<0.01).妊娠38周时对照组生活质量有下降,心理干预组生活质量评分较对照组有改善,主要表现在生理、心理、社会功能方面(P<0.01).结论:积极进行心理干预,有助于减少孕妇抑郁,改善生活质量.     

有主观抑郁症状的孕产妇精神障碍的发生率

目的 分析有主观抑郁症状的孕产妇精神障碍的发生率状况.方法 2020年3月1日至2021年2月28日,对在某三甲医院建档的孕妇和产妇分别使用9项患者健康问卷和爱丁堡产后抑郁量表进行心理筛查.对PHQ-9≥5分的孕妇、EPDS≥9分的产妇进行随访,使用简明国际精神神经访谈确认其精神障碍的发生状况.结果 随访342名女性中...     

孕妇的睡眠质量及心身状况初步研究

目的　了解孕妇在妊娠期的主观睡眠质量及心身状况。方法　采用匹茨堡睡眠质量指数量表 ( PSQI)及症状自评量表 ( SCL-90 )评定患者的主观睡眠质量及心身状况。结果　孕妇组与对照组 PSQI和 SCL-90各因子和总分进行比较 ,结果显示两组 PSQI睡眠时间、睡眠紊乱因子比较有显著性差异 ( P<0 .0 5)。SCL-90躯体化因子分统计差异有显著性 ( P<0 .0 5)。结论　与对照组比较 ,孕妇妊娠期睡眠时间增加 ,睡眠紊乱加重 ,同时躯体化不适症状多     

新生儿静脉血与脐带血及孕妇静脉血HBV病原学标记物相关性研究

目的 探讨慢性HBV感染孕妇所生新生儿脐带血与静脉血HBV标志物状况的一致性和相关性,以及与孕妇HBV感染标志物的相关性.方法 以HBsAg、HBeAg双阳性且HBV DNA＞1 ×105拷贝/ml孕妇及新生儿为研究对象,孕妇分娩前采集静脉血,新生儿于注射乙肝免疫球蛋白、乙肝疫苗前采集静脉血.在清洁和去除脐带表面污染血液,并用酒精消毒后,用注射器采集脐带血.HBsAg、抗HBs、HBeAg、抗HBe采用雅培微粒子化学发光法(美国雅培公司试剂,Abbott Architac i2000)检测,HBV DNA含量经COBAS TagMan HBV DNA定量检测仪检测.结果 共入组孕妇383例及所生新生儿,静脉血和脐带血HBsAg的阳性检出率分别为61.2％和63.9％,HBeAg阳性检出率分别为83.2％和83.5％,HBV DNA阳性检出率分别为56.0％和59.4％,静脉血和脐带血之间均有一致性.静脉血和脐带血间HBsAg、HBeAg和HBV DNA含量的相关性具有统计学意义(r=0.766、0.857、0.692,P＜0.000).新生儿静脉血和脐带血的HBeAg含量与孕妇的HBeAg含量具有相关性(r=0.362,P=0.000;r=0.352,P=0.000),而静脉血和脐带血的HBsAg含量与孕妇血清的HBsAg含量无相关性(r=0.023,P=0.785;r=0.04,P=0.604).结论 慢性HBV感染孕妇所生新生儿脐带血和静脉血HBV标志物状态有良好的一致性,可以以脐带血的HBV标志物反映新生儿静脉血HBV标志物.     

新冠肺炎流行期间北京市孕妇的焦虑抑郁症状及睡眠状况

目的:评估新冠肺炎流行期间孕妇的焦虑抑郁症状与睡眠问题及其相关因素。方法:2020年2月28日-4月26日,通过网络问卷平台调查北京四家助产机构就诊的885例孕妇的焦虑抑郁症状及睡眠问题。采用广泛焦虑量表(GAD-7)评估焦虑症状,采用患者健康问卷抑郁症状群量表(PHQ-9)评估抑郁症状,采用失眠严重程度指数量表(ISI)评估失眠症状。结果:本样本中焦虑症状、抑郁症状及失眠症状检出率分别为12.2%,24.6%和13.6%。缺少照顾(OR=1.73)、有分娩担忧(OR=3.95)及心理弹性差(OR=4.57)是焦虑症状的危险因素;家庭收入高(OR=1.94)、有分娩担忧(OR=2.39)及心理弹性差(OR=3.04)是抑郁症状的危险因素;除已婚外其他婚姻状况(OR=4.95)、孕周较长(13～27周,OR=2.03;28周及以上,OR=2.13)、有躯体疾病史(OR=1.77)、存在分娩担忧(OR=2.78)及心理弹性差(OR=1.67)是失眠症状危险因素。结论:新冠肺炎流行期间北京市孕妇焦虑症状、抑郁症状及失眠症状常见,尤其是存在分娩担忧及心理弹性差的孕妇。     

506例孕妇心理状态及影响因素分析

目的探讨孕妇的年龄、文化程度对心理状态的影响。方法采用症状自评量表对506例孕妇进行问卷调查。结果随孕妇年龄的增加、文化程度的提高,躯体化症状反应强度呈减弱趋势;同时,随年龄的增加,人际关系敏感、恐惧症状、精神病性症状反应强度明显增大。初中文化的孕妇主要以焦虑症状反应为主,并有显著性差异。结论建议结合孕妇不同年龄、不同文化给予相应的心理辅导。     

护理干预对健康孕妇心理健康及生活质量的影响

目的 探讨护理干预对健康孕妇心理健康及生活质量的影响.方法 应用症状自评量表(SCL-90)和汉化版简明健康调查表(SF-36)评估健康孕妇的心理健康状况及生活质量,并给予健康教育、心理疏导等护理干预,比较干预前后的评分.结果 干预前健康孕妇与中国常模比较,SCL-90评定除强迫因子无明显差异外,其它因子差异有显著性差异(P <0.01),护理干预后,SCL-90各因子除躯体化因子无明显差异外,其它因子较干预前明显降低(P <0.05、P <0.01);还有,健康孕妇的生活质量亦有明显变化,干预前与中国常模比较,除生理功能和躯体疼痛外,其余指标均有显著性差异(P <0.05),干预后与干预前比较,除生理功能和活力外,孕妇的生活质量其余6项指标变化显著(P <0.01).结论 护理干预不仅能改善健康孕妇的心理健康状况,还能提高孕妇的生活质量.     

大学生心理亚健康及心理症状的相关研究

目的 了解大学生心理亚健康及心理症状的情况及主要影响因素.方法 运用亚健康自评量表和症状自评量表(SCL-90)进行问卷调查,采用Excel建立数据库,并用SPSS 16.0对数据进行统计分析.结果 样本中心理亚健康及心理症状的发生频率为61.8％;性别对大学生的心理亚健康影响较大;偏执在来自农村或城镇上有显著差异(t...     

应激状态下大学生心理健康相关影响因素及应对方式

目的:以新型冠状病毒肺炎(COVID-19)疫情作为应激因素,调查疫情下大学生心理健康状况,分析应激状态下大学生心理健康状况的影响因素,制定有效的自助应对方式,为采取大学生心理健康教育提供依据.方法:使用 自编一般情况调查表、流调用抑郁自评量表(CES—D)、焦虑自评量表,对3975名大学生进行网络问卷调查,运用spearman相关分析方法及无序多分类Logistic回归模型进行统计分析.结果:502名(12.6％)名大学生可能存在抑郁症状,1066名(26.8％)名大学生肯定有抑郁症状,焦虑情绪发生率是13.9％,其中轻度、中度和重度焦虑发生率分别是12.30％、1.30％、0.30％.相关分析显示:是否存在抑郁症状与疫情信息、生活影响程度、学习影响程度、是否需要心理支援(r=0142,0.205,0.224,0.360;P＜0.05)成正相关;焦虑等级与疫情信息、生活影响程度、学习影响程度、是否需要心理支援、抑郁总分(r=0.126,0.134,0.134,0.274,0.496;P＜0.05)成正相关,而与疫情发生前是否存在心理疾病(r=-0.103;P＜0.05)成负相关.回归分析结果显示:接受负面疫情信息大于正面疫情信息、在家运动时间、对学习影响程度、焦虑标准得分都影响抑郁症状出现;而性别、专业、关注疫情的信息时间及抑郁情绪出现都影响焦虑程度.结论:应激(新冠肺炎疫情为例)对大学生心理健康状况产生一定影响,性别、专业、运动时间、关注疫情信息时间、正/负性信息、学习影响程度及抑郁焦虑等多个因素可能与应激状态下大学生心理变化相关,采取应对方式时,应充分考虑这些因素,制定个体化干预措施.     

The association of prenatal cocaine use and childhood trauma with psychological symptoms over 6 years

The use of cocaine and other drugs during pregnancy may have serious public health consequences. The objective of this study was to determine if the use of cocaine prenatally identifies women for ongoing risk of psychological symptoms. Four hundred and two women (207 cocaine using [C], 195 non-cocaine using [NC]) were assessed for rates of clinically elevated psychological symptoms shortly after childbirth, 6.5 months and 1, 2, 4 and 6 years after using the Brief Symptom Inventory (BSI). Generalized estimating equation modeling (GEE) was used to compare psychological symptom severity, controlling for confounding factors including early childhood trauma. Results indicated that women identified as having used cocaine during pregnancy had clinically elevated psychological distress (OR = 1.76, 95%CI = 1.15-2.71, p = 0.01), psychoticism (OR = 1.97, 95%CI = 1.41-2.76, p = 0.001), interpersonal sensitivity (OR = 2.34; 95%CI = 1.65-3.34; p < 0.0001) and phobic anxiety (OR = 1.86; 95%CI = 1.24-2.79) across all assessments compared to NC women. Childhood emotional abuse was also independently associated with psychological distress. Women who use cocaine during pregnancy should be recognized as at very high risk of ongoing clinically elevated psychological symptoms and should receive early and regular assessments and intervention for mental health and substance use problems.     

维吾尔族女性妊娠心理精神因素对分娩方式及妊娠结局的影响

目的探讨维吾尔族女性妊娠心理因素对分娩方式及妊娠结局的影响。方法对2006年1月至2011年1月乌鲁木齐市妇幼保健院分娩的132例健康维吾尔族女性妊娠心理研究,以汉密顿焦虑量表（HAS）和抑郁量表（HDS）评定精神心理状态,（其中12例终止妊娠,仅对120例进行分析）,对所有妊娠维吾尔族女性予以产科常规指导分娩方式的选择,观察其分娩方式及妊娠结局;并按妊娠心理精神因素及分娩方式不同分出剖宫产组、顺产组、产钳助娩组;并根据妊娠结局的不同分出良好妊娠结局及不良妊娠结局。结果 120例维吾尔族妊娠女性焦虑发生率35%,抑郁发生率28.3%,焦虑并抑郁发生率16.7%。剖宫产组、产钳助娩组的焦虑及抑郁评分明显高于顺产组,而妊娠结局不良的的焦虑及抑郁评分亦明显高于妊娠结局良好的评分。结论维吾尔族妊娠妇女心理精神因素对分娩方式及妊娠结局有一定影响。     

广东省翁源县妇女孕期抑郁水平及影响因素的调查分析

目的调查广东省翁源县妇女孕期抑郁的水平并分析其影响因素,为孕期心理保健提供重要依据。方法采用单纯随机抽样的方法,抽取在广东省翁源县妇幼保健院住院分娩的产妇进行问卷调查。结果 206名调查对象中,抑郁量表平均得分为（40.75±9.42）分,孕期抑郁症的患病率为14.56%。多因素分析表明,年龄≥35岁、家庭人均收入〈2000元/月、主观支持得分低的孕妇孕期抑郁水平高。结论年龄、家庭经济状况、主观支持情况对妇女孕期抑郁水平有影响,应有针对性地开展心理卫生健康教育和心理咨询工作。     

心理干预对产后妇女心理状况的影响

目的探究心理干预对产后妇女心理状况的影响。方法选取妇产科产妇212例,随机分为观察组和对照组各106例。观察组在刚住院时进行1次心理干预,生完孩子第三天干预1次,包括心理宣教引导和行为训练;产妇出院后,心理咨询师通过电话和上门2种方式进行干预,2周1次,共进行2次。对照组不做干预。两组产后1个月后均采用症状自评量表(SCL-90)对所有产妇进行心理测评。结果①产妇普遍存在躯体化,强迫,人际关系敏感,抑郁,焦虑,偏执等心理问题,其心理健康水平显著低于中国青年常模(t=2.73,4.13,2.73,2.22;P<0.01)结论采用心理干预方法能显著减少产妇不良情绪的发生,提高产妇对新角色的适应能力。     

Anxiety and Depressed Mood in Obese Pregnant Women: A Prospective Controlled Cohort Study

BackgroundThe psychological health in obese women during pregnancy has been poorly studied.ObjectiveTo compare levels of anxiety and depressed mood during pregnancy in obese versus normal-weight women.Methods63 obese pregnant women and 156 normal-weight controls were included prospectively before 15 weeks of gestation. Levels of state and trait anxiety and depressed mood were measured during the first, second and third trimester of pregnancy. A linear mixed-effect model with repeated measures was used to evaluate group differences.ResultsThe levels of state anxiety significantly increased from trimester 1 to trimester 3 in obese pregnant women (beta = 3.70; p = 0.007), while this parameter remained constant throughout pregnancy in normal-weight women. Levels of trait anxiety and depressed mood significantly decreased from trimester 1 to trimester 2 in controls, but not in obese pregnant women. Variables such as maternal education, ethnicity, marital state, psychological history and miscarriages, parity and smoking behaviour had significant effects on anxiety and/or depressed moods during pregnancy. Obese pregnant women show higher levels of anxiety and depressive symptomatology compared to normal-weight pregnant women.ConclusionInterventional programmes aiming at preventing the deleterious influence of maternal obesity on perinatal outcomes should include a psycho-educational program specifically tailored to this high-risk group.Key Words: Obesity, Pregnancy, Body mass index, Anxiety, Depressed mood, Psychological aspects, Obesity management     

300例产妇焦虑、抑郁状况和心理保健需求调查

目的分析产妇的心理健康状况,为开展针对性的孕产期心理保健指导干预提供依据。方法选择300名居住在闵行区的产妇,用调查问卷对其进行心理状况调查评估,问卷中包含焦虑自评量表(SAS)和抑郁自评量表(SDS)。结果对新生儿健康的担心和对分娩的恐惧是孕产妇主要担心的问题;是否母乳喂养(χ2=7.895,P0.01)、家人的支持和鼓励程度(χ2=9.450,P0.01)、工作/生活压力大小(χ2=10.393,P0.01)是影响产妇抑郁的重要因素,其中工作/生活压力(χ2=6.933,P0.01)又与产后焦虑症的发生有关,以上因素均有统计学意义;83.61%的产妇认为有必要开展孕产期心理指导,最希望得到家人的支持与鼓励。结论呼吁全社会关注孕产妇心理健康,通过广泛开展孕产期心理健康宣教,提倡母乳喂养,家人给予足够的关心和支持,能够对孕产妇的心理调节产生积极作用,降低焦虑、抑郁的发生。     

HIV,hepatitis B virus,hepatitis C virus,and syphilis among pregnant women attending antenatal care in Luanda,Angola: Seroprevalence and risk factors

Infectious diseases during pregnancy remain a public health concern, especially in a resource-limited setting. The study aimed to determine the seroprevalence and determinants of HIV and co-infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis among pregnant women attending antenatal care in Luanda, the capital city of Angola. A cross-sectional study was conducted with 1612 pregnant women screened for HIV during antenatal care. HIV-reactive were also screened for the HBV, HCV, and syphilis using immunoassay kits. A logistic regression model, adjusted odds ratios (AOR) and their 95% confidence interval (CI) were calculated with a level of significance set at 5%. The overall seroprevalence of HIV was 2.6%. About 13% of HIV-positive pregnant women were coinfected. From which, 7.5% were reactive to HBV and 5% to syphilis. There was no reactivity to HCV. Pregnant women younger aged than 25 years were significantly protected from HIV-infection (AOR, 0.43 [95% CI, 0.20-0.91], P = .026). The co-infection was 1.3 times (AOR, 0.04-41.0) in younger aged than 25 years, 7.0 times (AOR, 0.50-99.2) to residents in urbanized areas, and 1.4 times (AOR, 0.10-20.9) in pregnant women with a high educational level. In conclusion, infectious diseases are a public health burden among pregnant women in Luanda. However, include an integrated antenatal screening mainly in urbanized areas is crucial to reduce the spread of infectious diseases in different communities of Angola.     

广州妊娠期糖尿病孕妇生活事件与孕妇心理健康状况的关系

目的:探讨广州妊娠期糖尿病孕妇(GDM)生活事件与心理健康的关系。方法:采用孕妇生活事件问卷和症状自评量表(SCL-90)对111名妊娠期糖尿病孕妇进行调查分析。结果:孕妇生活事件总分为(188.99±147.92)分,客观事件的得分比主观事件的分数高,负性事件比正性事件得分高;排名前10名生活事件为受到家人更多关心、担心胎儿发育会受到工作影响(如噪音、放射线等)、睡眠、饮食、穿着等生活习惯的改变等;在各维度中,孕妇生活事件总分与焦虑维度的相关系数最高(r=0.288,P0.05),主观事件与抑郁维度系数最高(r=0.271,P0.05),负性事件(r=0.323,P0.05)、客观事件(r=0.279,P0.05)与焦虑维度存在正相关。结论:妊娠期糖尿病孕妇生活事件和孕妇心理健康状况有关。采取有效的措施,减少负性、主观事件的发生,帮助妊娠期糖尿病孕妇更好地应对妊娠和顺利分娩。     

TORCH感染与不良妊娠关系的分析

目的比较正常妊娠和异常妊娠妇女血清TORCH感染情况。方法采用酶联免疫吸附试验（ELISA）对3851例妊娠（包括3449例正常妊娠和402例异常妊娠）妇女进行TORCH-IgM抗体检测。结果 3449例正常妊娠孕妇血清弓形虫（TOX）、风疹病毒（RUV）及巨细胞病毒（CMV）IgM抗体阳性率分别为0.32%、0.20%、1.88%,总阳性率为2.41%;402例异常妊娠妇女TOX、RUV、CMVIgM抗体阳性率分别为3.48%、2.74%、9.20%,总阳性率为15.42%。异常妊娠妇女TOX、RUV、CMV的IgM阳性率以及TORCH感染总阳性率明显高于正常妊娠孕妇,差异均有统计学意义（P〈0.05）。结论 TORCH感染与不良妊娠密切相关,应重视TORCH感染的早期筛查和诊治。     

Titering of 2009 pandemic H1N1 influenza virus hemagglutinin inhibition antibody in nonvaccinated pregnant women in Shiraz, Southern Iran

Influenza may cause severe complications for pregnant women. In this study antibody response against 2009 H1N1 influenza virus in pregnant women was investigated. This seroprevalance cross sectional and questionnaire based study was conducted using a convenient sampling method. Blood samples of pregnant women were checked for antibodies against 2009 H1N1 influenza virus using hemagglutination inhibition assay. An antibody titer level of ≥ 1:40 dilution was considered as the protective level. 167 (43.60%) of 383 pregnant women who participated in this study had protective antibody levels against this virus. 62 (35.63%) of 3rd trimester, 79 (46.74%) of 2nd trimester, and 21(52.50%) of 1st trimester pregnant women were immune respectively (χ2(for trend) = 8.20, p < 0.004). Lack of protective antibody level was significantly seen more in pregnant women of 3rd trimester of pregnancy (OR = 2.37, CI = 1.09-5.18). Pregnant women with higher education (OR = 1.67, CI = 1.02-2.73) and those with history of anemia (OR = 2.09, CI = 1.18-3.68) had more immunity. Older women (OR = 0.95, CI = 0.91-0.99) and those with history of psychological diseases (OR = 0.19, CI = 0.05-0.70) had less immunity. Vaccination of pregnant women, especially those who are in the higher trimesters of pregnancy, older, or less educated, against the 2009 H1N1 influenza virus should be continued.