初产妇产前焦虑相关因素分析及其与分娩方式的关系

目的 调查初产妇产前情绪障碍的发生情况及可能的影响因素,并分析其与分娩方式的关系.方法 选择2004年12月-2005年12月健康初产妇590例,采用自制问卷调查产妇一般社会心理状况,用状态一特质焦虑量表和SDS抑郁量表对产妇进行心理评估.结果 选取569例的问卷调查结果,根据焦虑、抑郁的评分结果分别将其分为焦虑组114例,对照组455例;抑郁组159例.对照组410例;焦虑组产妇,选择剖宫产的比例显著增高(45.61%,32.53%,X2=6.85,P＜0.01),而试产成功率显著低于对照组(19.35%,47.88%,X2=26.30,P＜0.01).抑郁组产妇无指征剖宫产的比例显著高于对照组(46.54%,31.95%,X2=10.21,P＜0.01),而试产成功率显著低于对照组(31.76%,46.59%,X2=9.13,P＜0.01).产前焦虑与以下因素有关:害怕分娩、担心孩子、了解分娩知识、经济地位较高、产妇年龄及自身经济状况.结论 初产年龄偏大、经济状况差、家庭支持不足、担心自身及孩子安全及对疼痛的恐惧等因素与产前情绪障碍有关,而产前情绪障碍会影响分娩质量及分娩方式的选择,增加剖宫产的概率.

Related factor analysis of prenatal anxiety and its relationship with delivery mode of primiparae

Objective To investigate the prenatal emotional disorder of the primipame and the related factors,and to analyze its influence on the delivery mode.Methods In the prospective cohort study,590 healthy primiparase were asked to complete a self-compiled questionnaires for their general social mental state,state-trait anxiety inventory(STAI)and self-rating depression scale(SDS).Results Questionnaires of 159 patients were selected and these patients were divided into the anxiety group(114 cases)and the control group(455 cases),the depression group(159 cases)and the control group(410 cases).The ratio of selective cesarean section in the anxiety group was significantly higher(45.61%,32.53%,X2=6.85,P＜0.01),while the successful trial of labor were less than that of the control group(19.35%,47.88%,X2=26.30,P＜0.01).The ratio of selective cesarean section in the depression group was significandy higher than that of the control group(46.54%,31.95%,X2=10.21,P＜0.01),while the successful trial of labor were less than that of the control group(31.76%.46.59%,X2=9.13,P＜0.01).Single-factor analysis showed that prenatal anxiety related to the following factors:fear of childbirth,worried about their children,knowledge for childbirth,high economic status,maternal age and their own economic situation.Conclusions Higher incidence and risk factors of anxiety or depression before delivery,such as advanced delivery age,bad economic condition,weak family support,worrying about the safety of babies and themselves,are found in our study.Prenatal emotional disorder would affect the quality of labor and delivery options,and lead the high risk of cesarean section.