孕妇产前心理状况与分娩方式的关系研究

目的通过分析孕妇产前心理状况和最终分娩方式之间的关系,探索能够有效降低剖宫产发生率的方法。方法使用量表、自制调查问卷分别于孕35周、孕38周、产后72h对85例孕产妇进行心理状况评定,分析孕妇心理与最终分娩方式的相关关系。结果无指征剖宫产组孕妇孕38周及产后72h抑郁（t=12．827～15．832,均P〈0．05）、恐怖（t=12．967～18．657,均P〈0．05）、焦虑（t=12．803～15．632,均P〈0．05）均高于有指征剖宫产组和自然分娩组。自然分娩组幸福感得分高于无指征剖宫产组（t=2．751,P=0．009）,两组的期望值、文化程度、职业差异均有统计学意义（X^2=6．582～7．339,均P〈0．05）;年龄、职业、期望等因素均与孕产妇不同阶段的某些心理因子得分存在一定的相关性（r=0．042-0．605,均P〈0．05）。结论孕产妇心理状况如恐惧、焦虑、抑郁会影响最终的分娩方式,通过对这些不良的心理状况进行干预,有望降低孕产妇剖宫产发生率。

Relationship between prenatal psychological status and delivery mode

Objective To analyze the relationship between prenatal psychological status and final delivery mode and explore effective methods to reduce cesarean section rate. Methods Symptom self-rating scale, self-made questionnaire, and general well-being schedule were used to evaluate the psychological status of 85 pregnant women at 35 gestational week, 38 gestational week and 72 hours after delivery. The relationship between psychological status of them and delivery mode was analyzed with statistics method. Results The depression （t = 12. 827-15. 832, all P 〈 0.05 ）, terror（ t = 12.967-18.657, all P 〈 0. 05 ） and anxiety （t = 12. 803-15. 632, all P 〈 0. 05 ） scores of pregnant women at 38 gestational week and 72 hours after delivery in the group without indication of cesarean section were higher than those in the group with indication of Cesarean section and those in natural delivery group. The happiness score in natural delivery group was higher than that in the group without indication of cesarean section （ t = 2.751, P = O. 009）, and the differences in expected value, educational level and occupation between two groups were statistically significant （X2 = 6.582-7. 339, all P 〈 0.05）. Age, occupation and expectation were related with some psychological agents scores at different stages （ r = 0. 042-0. 605, all P 〈 0. 05 ）. Conclusion Psychological status such as fear, anxiety and depression will affect the final mode of delivery. The intervention of these adverse psychological conditions is expected to reduce cesarean section rate.