高危孕妇焦虑抑郁症状发生率及相关危险因素

背景：高危孕妇与普通孕妇相比在妊娠期会出现更多的并发症，高危因素作为一种应激因素更易诱发孕妇产生焦虑、抑郁等负面情绪症状。目前国内外对高危孕妇焦虑、抑郁症状的研究相对较少。
　　目标：调查产科高危妊娠孕妇焦虑、抑郁症状发生率及其相关危险因素。
　　方法：对197例孕中期（16-20周）的高危孕妇在妊娠最后4月每月进行综合性医院焦虑/抑郁量表（HAD）评估和风险因素调查。产后3-7天、42天及3月进行爱丁堡产后抑郁量表（EPDS）评估和风险因素调查。
　　结果：入组时高危孕妇HAD焦虑均分：3.69(2.76)，抑郁均分：3.42(2.53)。焦虑症状14例(7.18%)，抑郁症状10例(5.13%)。多因素分析显示，怀孕有无保胎（OR：8.162,95%CI：1.213-54.914）和乙肝阳性（OR：8.912,95%CI：1.052-75.498）与焦虑症状相关。尿糖阳性（OR：30.529,95%CI：1.312-710.610）和既往出血史（OR：7.122,95%CI：1.015-49.984）与抑郁症状相关。孕期影响高危孕妇焦虑、抑郁症状的因素有：近3月孕妇健康状况、担心胎儿健康、夫妻关系、婆媳关系等。
　　结论：高危妊娠孕妇焦虑、抑郁症状较常见。近3月孕妇健康状况、婆媳关系、夫妻关系、担心胎儿健康是高危孕妇孕期焦虑、抑郁症状的风险因素。

Factors associated with signiifcant anxiety and depressive symptoms in pregnant women with a history of complicaitons

Background:The occurrence of complicaitons during the gestaiton period is higher among pregnant women with a history of complications than among pregnant women without previous complications. High-risk pregnancy can cause negative emotional symptoms such as anxiety and depression in pregnant women. Current research on anxiety and depression symptoms in pregnant women is sparse.
Aims: To examine the incidence of anxiety and depression symptoms in pregnant women with a history of previous complicaitons or high risk pregnancy and related risk factors.
Methods:Women with a history of previous complications in pregnancy or current ‘high risk’ pregnancy (e.g. test tube feritlizaiton, etc.) were classiifed as ‘high risk’. 197 of these ‘high risk’ women who were in their second trimester (16 to 20 weeks) underwent a monthly comprehensive assessment using the Hospital Anxiety and Depression Scale (HAD) in the last 4 months of the gestaiton period. The Edinburgh Postnatal Depression Scale (EPDS) was used for assessment and risk factor invesitgaiton 3 to 7 days, 42 days, and 3 months atfer childbirth.
Results:The mean (sd) HAD anxiety score among ‘high-risk’women at the itme of enrollment was 3.69 (2.76) and depression score was 3.42 (2.53). Signiifcant anxiety symptoms and depression symptoms were found in 14 cases (7.18 %) and 10 cases (5.13%), respecitvely. Mulitvariate analysis showed a correlaiton between anxiety symptoms and history of miscarriage (OR: 8.162, 95%CI: 1.213 to 54.914)and testing positive for hepaitits (OR: 8.912, 95%CI: 1.052 to 75.498). Depressive symptoms were correlated with glucose posiitve urine (OR: 30.529, 95%CI: 1.312 to 710.610) and history of hemorrhaging (OR: 7.122, 95%CI: 1.015 to 49.984). General factors associated with anxiety and depression symptoms include paitents’ health status in the recent 3 months, concerns about fetal health, quality of marital relaitonship, and relaitonship with in-laws.
Conclusions:Anxiety and depression symptoms are commonly seen in pregnant women with a history of previous complicaitons or current ‘high risk’ pregnancy. Paitents’ recent health status, relaitonship with in-laws, marital quality and concerns about fetal health are associated with anxiety and depression symptoms during pregnancy.