医源性多胎妊娠患者的焦虑抑郁现状及影响因素分析

目的 调查医源性多胎妊娠患者的焦虑、抑郁现状，并分析影响其心理健康的相关因素。方法 选取本市某医院生殖中心体外授精-胚胎移植助孕获得多胎妊娠的患者进行调查，采用自编的一般情况调查表及焦虑自评量表（self rating anxiety scale，SAS）、ZUNG氏抑郁量表（self-rating depressive scale，SDS）来收集患者资料，用Epi Data 3.1、SPSS 16.0进行数据库的建立、数据的整理及统计分析。结果 本研究共调查240例医源性多胎妊娠患者，按照患者不孕类型分为原发不孕和继发不孕两组，两组间在不孕原因方面，差异有统计学意义（（口恶）²=7.871，P=0.049）。研究对象中焦虑检出率为47.50%、抑郁检出率为66.25%。多因素Logistic回归分析结果显示：继发不孕（OR=2.274，95%CI：1.312~3.941，P=0.003）和注重男孩（OR=4.591，95%CI：2.492~8.459，P<0.001）是影响SAS评分的危险因素；既往无疾病史（OR=0.248，95%CI：0.074~0.832，P=0.024）是SDS评分的保护因素，家庭人均月收入较高（OR=4.105，95%CI：1.204~14.004，P=0.024）、渴望生育男孩（OR=2.303，95%CI：1.161~4.568，P=0.017）是SDS评分的危险因素。结论 继发不孕、渴望生育男孩是医源性多胎妊娠患者焦虑发生的危险因素；高收入水平、渴望生育男孩是抑郁发生的重要危险因素。

Analysis on the status and influencing factors of anxiety and depression in Iatrogenic multiple pregnancy women

Objective To investigate the status of anxiety and depression in iatrogenic multiple pregnancy, and to analyze the relevant factors which affect their mental health. Methods The multiple pregnancy patients with IVF-ET (in vitro fertilization-embryo transfer) were selected from a reproductive center in Hefei, Anhui. And we collected the data with the self-designed General Situation Questionnaire, the pregnancy stress scale (SAS) and Self-rating depression scale (SDS) to evaluate the anxious and despondent status of the patients. Results A total of 240 patients with multiple pregnancy from a reproductive center in Hefei were recruited. According to the patient's infertility type, they were divided into two groups with primary infertility and secondary infertility, and the difference between the two groups in the cause of infertility was statistically significant((口恶)2=7.871,P=0.049). The anxiety and depression detection rate was 47.50% and 66.25% respectively. Multivariate regression analysis showed that SAS score was correlated with and secondary infertility(OR=2.274, 95% CI:1.312-3.941, P=0.003), pay attention to the sex of the fetus(OR=4.591, 95% CI:2.492-8.459, P<0.001). No family history of disease(OR=0.248, 95% CI:0.074-0.832, P=0.024)were protective factors of SDS scores. The average monthly income(OR=4.105, 95% CI:1.204-14.004, P=0.024)and pay attention to the sex of the fetus (OR=2.303, 95% CI:1.161-4.568, P=0.017)was risk factor of SDS scores. Conclusions Secondary infertility and eagering to give birth with boys may be a risk factor of iatrogenic sexual anxiety in patients with multiple pregnancy. A high level of income, eagering to give birth with boys are important risk factors for depression.