产前抑郁对新生儿出生体质量和分娩孕周的影响

目的探讨产前抑郁与胎儿出生体质量和分娩孕周的相关性。方法选取2011年8月-2018年5月在舟山市妇幼保健院产检的1 616例孕妇为研究对象,采用自编问卷采集研究对象一般社会人口学信息、器质性疾病、精神疾病、创伤史及分娩史,采用抑郁自评量表(SDS)评价抑郁状态,采用焦虑自评量表(SAS)评价焦虑状态,并从舟山市妇幼保健院电子医疗系统中提取分娩的相关信息,采用多元线性回归分析产前抑郁与胎儿出生体质量和分娩孕周的相关性。结果孕期无抑郁组脑力劳动者、高孕次人数、出现早孕反应及孕期存在焦虑的比例均少于孕期有抑郁组,差异均有统计学意义(均P<0. 001);无抑郁组平均文化水平高于有抑郁组,差异有统计学意义(P<0. 001)。多元线性回归分析结果显示,产前抑郁与孕妇分娩孕周无关;孕早期中重度抑郁能降低胎儿出生体质量(β=-69. 76,P=0. 039 1),各怀孕阶段中至少1期(β=-59. 05,P=0. 005 1)、至少2期(β=-61. 49,P=0. 027 1)出现抑郁均能降低胎儿出生体质量,至少1期出现中重度抑郁(β=-88. 03,P=0. 004 5)对降低胎儿出生体质量的效应更为显著。结论产前抑郁与胎儿出生体质量呈负相关关系,但与出生孕周无关,因此要加强孕妇的心理健康管理,维护母婴健康。

Effects of prenatal depression on birth weight and gestational age

Objective To observe associations between prenatal depression and birth weight and gestational age.Methods A total fo 1 616 pregnant women were enrolled in the Maternal and Child Care Hospital of Zhoushan from September 2011 to May 2018,and a selfmade questionnaire was applied to collect information including demographic characteristics,medical conditions,mental disorder history,reproductive history and trauma history.The Self-Rating Depression Scale(ADS) and Self-Rating Anxiety Scale(SAS) were respectivelyused to evaluate the depression status and anxiety status during the first,second and third trimester pregnancy,and the delivery-related information was extracted from electronic medical system of Zhoushan Maternal and Child Care Hospital.The multiple linear regression model was used to analyze the relationship between prenatal depression and birthweight and gestational age.Results The proportion of mental laborer,population with high gravidity and pregnant reaction in the depression group was significantly higher than those in the non-depressed group,while the average cultural level was lower than that of the non-depression group.Antenatal depression was not associated with gestational age;but moderate or severe depression in the first trimester was associated with significant decrease in birth weight(β =-69.76,P = 0.039 1),and women with at least one or two trimesters with antenatal depression(β =-59.05,P = 0.005 1;β =-61.49,P = 0.027 1) was also related with lower birth weight compared to non-depressed women after adjustment for potential confounders,and women with at least one trimester with moderate or severe depressive status was negatively associated with birth weight(β =-88.03,P = 0.004 5).Conclusion Prenatal depression was associated with lower birth weight,but not related to gestational age.It indicates that maternal mental health during pregnancy must be cared for improving maternal and infant health.