孕产妇的心理状况与分娩方式的关系

目的研究孕产妇的心理状况随孕周进展的动态变化及其分娩结局，寻求降低剖宫产率的有效对策。方法采用自制问卷、症状自评量表(scL-90)、总体幸福感量表，对89例孕产妇分别于孕35周、38周、产后72小时进行心理状况的评定分析。结果89例孕产妇中自然分娩48例，占53.93％；剖宫产41例，占46.07％(其中无产科指征12例，占29.27％)。无指征剖宫产组分娩前后焦虑、恐怖、抑郁因子分均高于自然分娩及有指征剖宫产组，抑郁因子分均高于自然分娩组及有指征剖宫产组，差异显著(P＜0.01)；无指征剖宫产组总体幸福感值低于自然分娩组，差异极显著(P＜0.001)。相关分析表明幸福感、对生育的期望、文化程度与孕产妇的症状水平呈显著负相关(P＜0.01)，分娩方式与孕产妇心理状况呈显著正相关(P＜0.01)。结论无产科指征的剖宫产主要是与随孕周进展乃至分娩而渐进的焦虑、恐怖、抑郁有关。故有针对性的进行心理干预可望降低剖宫产率。

Relationship between psychological state and the mode of delivery in pregnant women

Objective\ To investigate the dynamic changes of psychological states and the results of delivery in pregnant women,simultaneously,study the effective way to reduce the rate of cesarean section.Methods\ Through applying the self-compiled test paper,the self-evaluating state table (SCL-90)and the table of overall feeling of happiness,we assessed the psychological states of 89 pregnant women.The results were recorded at 35 and 38 weeks of gestation and 72 hours postpartum.Results\ 48 delivered vaginally(53 93%).4 were managed by cesarean section(46 07%),including 12 non-indicated cesarean section(29 27%).The mark of anxiety,terror and depression factors increased in the group of non-indicated cesarean section before and after dilivery compared with the group of vaginal delivery and indicated cesarean section.There was remarkable difference(P<0 01).The value of overall feeling of happiness in the group of non-indicated cesarean section was less than that in the group of vaginal delivery.The difference was extremely significant(P<0 001).The relevant analysis showed that the feeling of happiness,the desire of labor and educational level were related negatively to the level of symptom during pregnancy(P<0 01).The mode of delivery was related positively to the psychological state of pregnant women(P<0 01).Conclusion\ Non-indicated cesarean section is mainly interrelated to anxiety,terror and depression that proceed gradually during pregnancy and delivery.So it is suggested that the aimed psychological education be beneficial to decrease the rate of cesarean section.