妊娠晚期孕妇症状群发生现状及相关因素分析

目的 调查并识别妊娠晚期孕妇症状群类型,进一步探讨社会支持与不同症状群之间的关系。方法 以2019年1月至2020年12月北京市3家医院产科门诊妊娠晚期孕妇作为研究对象进行问卷调查,主要内容包括基本情况、孕期症状发生情况、社会支持情况。采用Promax斜交旋转法对妊娠晚期发生率>40%的症状量表评估所得症状进行探索性因子分析,并采用单、多因素对妊娠晚期孕妇症状群发生影响因素进行分析。结果 本研究共纳入5 012名妊娠晚期孕妇,年龄24~44岁,孕周35~<41周,以35~36周为主,占57.0%。家庭月收入以≥10 000元为主,占68.9%。孕前BMI以<24.0为主,占71.0%。社会支持得分为（68.25±4.78）分。症状发生频率排在前5位的是体重增加、精力不足、感到昏昏欲睡、出汗、难以入睡,各症状群平均得分最高者为身体形象症状群（0.89±0.46）分,其次分别为一般躯体症状群（0.81±0.48）分、神经精神症状群（0.79±0.43）分、肢体症状群（0.66±0.29）分。多元线性回归分析结果显示,孕周（β’=0.236）、运动频率（β’=-0.192）是妊娠晚期孕妇发生一般躯体症状群的影响因素。月收入（β’=-0.118）、社会支持得分（β’=-0.136）是妊娠晚期孕妇发生神经精神症状群的影响因素。孕周（β’=0.229）、孕前BMI（β’=0.086）是妊娠晚期孕妇发生身体形象症状群的影响因素;孕周（β’=0.353）是妊娠晚期孕妇发生肢体症状群的影响因素。结论 受多种因素的影响,妊娠晚期孕妇存在多个身心症状,而社会支持与其具有一定相关性,这对临床早期识别高危人群,及时展开针对性干预措施具有重要作用。

Current status and related factors of symptom clusters of pregnant women in late pregnancy

Objective To investigate and identify the types of symptom clusters of pregnant women in late pregnancy, and to further explore the relationship between social support and different symptom clusters. Methods From January 2019 to December 2020, pregnant women in late pregnancy in the obstetric outpatient clinics of three hospitals in Beijing were investigated by questionnaire, mainly including basic information, occurrence of symptoms during pregnancy, and the status of social support. The Promax oblique rotation method was used to perform exploratory factor analysis on the symptoms evaluated by the symptom scale with an incidence rate of> 40% in late pregnancy, and single and multiple factors were used to analyze the influencing factors of the symptom clusters of pregnant women in late pregnancy. Results A total of 5 012 pregnant women in late pregnancy were enrolled in this study, aged 24-44 years old, with gestational age 35 to <41 weeks, 35 to 36 weeks dominated, accounting for 57.0%. The monthly household income was mainly ≥10 000 yuan, accounting for 68.9%. BMI of pre-pregnancy was mainly <24.0, accounting for 71.0%. The score of social support was （68.25±4.78） points. The top 5 symptom occurrence frequencies were weight gain, lack of energy, feeling drowsy, sweating, and falling asleep difficulty. The symptom cluster with the highest average score was body image symptoms （0.89±0.46） points, followed by general physical symptoms （0.81±0.48） points, neuropsychiatric symptoms （0.79±0.43） points, limb symptoms （0.66±0.29） points. The results of multiple linear regression analysis showed that gestational age （β'=0.236） and exercise frequency （β'=-0.192） were factors affected the general physical symptoms of pregnant women in late pregnancy. Monthly income （β'=-0.118） and the score of social support （β'=-0.136） were factors affected the neuropsychiatric symptoms in late pregnancy. The gestational age （β'=0.229） and the BMI of pre-pregnancy （β'=0.086） were factors affected the body image symptoms of pregnant women in late pregnancy. Gestational week （β'=0.353） was factor affected the limb symptoms of pregnant women in late pregnancy. Conclusion Affected by a variety of factors, pregnant women in late pregnancy have multiple physical and mental symptoms, and social support has a certain correlation with them. This plays an important role in identifying high-risk population in the early clinical stage and launching targeted intervention measures in a timely manner.