妊娠压力在产妇社会支持与产后创伤后应激障碍间的中介效应

目的探讨妊娠压力在产妇社会支持与产后创伤后应激障碍间的作用机制,为产妇心理健康的早期筛查和干预提供参考。方法采用便利抽样法,选取2019年11月—2020年1月上海市某三甲妇产科专科医院的1178名进行产后检查的产妇作为研究对象,采用一般情况调查表、围生期创伤后应激障碍问卷、中文版领悟社会支持量表和妊娠压力量表对其进行调查。本研究共发放调查问卷1178份,回收有效问卷1162份,有效回收率为98.64%。结果社会支持与妊娠压力、产后创伤后应激障碍呈负相关(P<0.01),妊娠压力与产后创伤后应激障碍呈正相关(P<0.01);妊娠压力在社会支持与产后创伤后应激障碍间的中介效应为-0.229,占总效应的58.9%。结论妊娠压力是产妇社会支持与产后创伤后应激障碍间的中介变量,社区保健人员及医务人员应关注产妇的妊娠压力水平,在产妇进行产检时进行妊娠压力水平的评估,为后续采取干预措施提供依据,以降低产后创伤后应激障碍的严重程度和发生率。

Mediating effects of pregnancy stress on social support and postpartum post-traumatic stress disorder in parturient women

Objective To explore the mechanism of pregnancy stress between maternal social support and postpartum post-traumatic stress disorder(PTSD),so as to provide reference for early screening and intervention of maternal mental health.Methods Using the convenient sampling method,a total of 1178 parturient women who underwent postpartum examinations in a ClassⅢGrade A obstetrics and gynecology specialized hospital in Shanghai from November 2019 to January 2020 were selected as the research objects.General data questionnaire,Perinatal Post-Traumatic Stress Disorder Questionnaire,Chinese Version of Perceived Social Support Scale and Pregnancy Stress Rating Scale were used to investigate.A total of 1178 questionnaires were issued in this study and 1162 valid questionnaires were recovered,with an effective recovery rate of 98.64%.Results Social support was negatively correlated with pregnancy stress and postpartum PTSD(P<0.01),and pregnancy pressure was positively correlated with postpartum PTSD(P<0.01).The mediating effect of pregnancy stress between social support and postpartum PTSD was-0.229,accounting for 58.9%of the total effect.Conclusions Pregnancy stress is a mediating variable between maternal social support and postpartum PTSD.Community health workers and medical staff should pay attention to the pregnancy stress level of parturient women and evaluate the pregnancy stress level during prenatal examinations so as to provide basis for subsequent intervention measures and to reduce the severity and incidence of postpartum PTSD.