Study on the sleep quality of perinatal women and the influencing factors of postpartum sleep
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摘要:
目的 调查孕产妇睡眠质量，探析女性产后睡眠质量的影响因素，为制定干预措施提供依据。 方法 调查时间为2018年4月-2019年7月，女性在孕期产检时完成第一次问卷调查，产后3~7 d完成第二次问卷调查。以匹兹堡睡眠问卷评估睡眠情况。同时收集一般情况、产科情况、孕产期抑郁及产妇母乳喂养信心。采用多元线性回归分析模型分析影响产后睡眠质量的预测因素。 结果 共367名女性完成两次问卷调查。孕期睡眠障碍检出率为26.4%，产后睡眠障碍检出率为23.7%。主观睡眠质量、睡眠潜伏期和睡眠紊乱是女性孕期和产后睡眠质量较差的3个方面。孕期睡眠质量与产后睡眠质量中度相关。多元线性回归分析提示，孕期睡眠质量、产后抑郁及产妇母乳喂养信心是影响产后女性睡眠的3个重要因素，可共同解释产后睡眠质量总变异的34.5%。 结论 孕产妇睡眠质量值得医护人员重视，建议从孕期即开展促进睡眠的健康教育及指导，减少产后抑郁、提高母乳喂养效能可提高产妇产后睡眠质量。 -
关键词:
- 孕妇 /
- 产妇 /
- 睡眠 /
- 多元线性回归分析模型 /
- 横断面研究
Abstract:Objective To survey the sleep quality of perinatal women, and to explore the influence factors for postpartum sleep quality so as to provide basis for the formulation of intervention measures. Methods The research was conducted from April 2018 to July 2019. A repeated questionnaire method was used. The first survey was completed during the pregnancy check-up, and a questionnaire survey again 3-7 days after delivery was conducted. Pittsburgh sleep quality index was used to measure the sleep quality of the participants. At the same time, the general information, obstetric data, depression during pregnancy and pregnancy, and confidence in breastfeeding were collected. The predictors of postpartum sleep quality were analyzed by multiple linear regression analysis. Results A total of 367 pregnant women completed questionnaire twice. Subjective sleep quality, sleep latency and sleep disorders were three aspects of poor maternal sleep quality. The proportion of sleep disorder in pregnant women was 26.5%, and 23.7% in maternal women. Postpartum sleep quality was moderately related to sleep quality during pregnancy. Multiple linear regression analysis showed that the factors influencing sleep quality of postpartum women included sleep quality during pregnancy, postpartum depression, and maternal breastfeeding efficacy. These factors explained 34.5% of the total variance of postpartum sleep quality. Conclusions The incidence of sleep disorders in perinatal women is high. It is recommended to carry out health education and guidance to promote sleep from pregnancy. Reducing postpartum depression and improving breastfeeding efficiency can improve maternal sleep quality. -
Key words:
- Pregnant woman /
- Maternal /
- Sleep /
- Multiple linear regression analysis model /
- Cross-sectional study
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表 1 调查对象基本特征及产后PSQI比较(n=367) [n (%)]
Table 1. Basic characteristics and comparison between different group of PSQI (n=367) [n (%)]
变量 n (%) 产后PSQI(分) χ2值 P值 睡眠好(≤7) 睡眠差(＞7) 年龄(岁) 4.622 0.328 ＜21 7(1.9) 5(1.8) 2(2.3) 21~ 87(23.7) 65(23.2) 22(25.3) 26~ 190(51.8) 144(51.4) 46(52.9) 31~ 69(18.8) 52(18.6) 17(19.5) ≥35 14(3.8) 14(5.0) 0(0.0) 民族 3.862 0.049 汉族 332(90.5) 258(92.1) 74(85.1) 少数民族 35(9.5) 22(7.9) 13(14.9) 文化程度 0.453 0.929 初中及以下 59(16.1) 46(16.4) 13(14.9) 高中或中专 177(48.2) 133(47.5) 44(50.6) 大学 128(34.9) 99(35.4) 29(33.3) 硕士及以上 3(0.8) 2(0.7) 1(1.1) 居住区域 1.329 0.249 城市 111(30.2) 89(31.8) 22(25.3) 农村 256(69.8) 191(68.2) 65(74.7) 居住方式 1.085 0.781 夫妻单独居住 142(38.7) 108(38.6) 34(39.1) 与公婆同住 122(33.2) 95(33.9) 27(31.0) 与自己父母同住 95(25.9) 70(25.0) 25(28.7) 其他方式 8(2.2) 7(2.5) 1(1.1) 家庭月收入(元) 5.532 0.137 ＜2 000 17(4.6) 12(4.3) 5(5.7) 2 000~ 180(49.0) 129(46.1) 51(58.6) 5 000~ 143(39.0) 118(42.1) 25(28.7) ≥10 000 27(7.4) 21(7.5) 6(6.9) 计划妊娠 4.003 0.045 否 104(28.3) 72(25.7) 32(36.8) 是 263(71.7) 208(74.3) 55(63.2) 妊娠并发症或合并症 3.008 0.083 无 350(95.4) 270(96.4) 80(92.0) 有 17(4.6) 10(3.6) 7(8.0) 分娩方式 2.327 0.312 自然分娩 182(49.6) 145(51.8) 37(42.5) 剖宫产 175(47.7) 128(45.7) 47(54.0) 阴道助产 10(2.7) 7(2.5) 3(3.4) 新生儿出生后是否转科 4.952 0.026 是 97(26.4) 82(29.3) 15(17.2) 否 270(73.6) 198(70.7) 72(82.8) 是否母乳喂养 3.126 0.077 是 359(97.8) 276(98.6) 83(95.4) 否 8(2.2) 4(1.4) 4(4.6) 
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表 2 女性孕期及产后PSQI各因子得分情况(n=367) [n (%)]
Table 2. Scores of PSQI factors during pregnancy and postpartum (n=367) [n (%)]
PSQI量表因子 0分 1分 2分 3分 各因子平均得分(x±s) 孕期 主观睡眠质量 32(8.7) 250(68.1) 73(19.9) 12(3.3) 1.18±0.62 睡眠潜伏期 40(10.9) 119(32.4) 130(35.4) 78(21.3) 1.67±0.93 睡眠时间 328(89.4) 21(5.7) 14(3.8) 4(1.1) 0.17±0.53 睡眠效率 173(47.1) 102(27.8) 50(13.6) 42(11.4) 0.89±1.03 睡眠紊乱 3(0.8) 164(44.7) 190(51.8) 10(2.7) 1.56±0.56 使用睡眠药物 360(98.1) 5(1.4) 0(0.0) 2(0.5) 0.03±0.25 日间功能紊乱 223(60.8) 140(38.1) 4(1.1) 0(0.0) 0.40±0.51 产后 主观睡眠质量 64(17.4) 222(60.5) 69(18.8) 12(3.3) 1.08±0.70 睡眠潜伏期 47(12.8) 146(39.8) 110(30.0) 64(17.4) 1.52±0.93 睡眠时间 295(80.4) 52(14.2) 10(2.7) 10(2.7) 0.28±0.65 睡眠效率 201(54.8) 77(21.0) 48(13.1) 41(11.2) 0.84±1.05 睡眠紊乱 13(3.5) 180(49.0) 160(43.6) 14(3.8) 1.48±0.63 使用睡眠药物 356(97.0) 4(1.1) 4(1.1) 3(0.8) 0.06±0.35 日间功能紊乱 219(59.7) 131(35.7) 17(4.6) 0(0.0) 0.45±0.58
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表 3 产后睡眠质量的相关性分析
Table 3. Correlation analysis of postpartum sleep quality
变量 孕期焦虑抑郁 孕期睡眠 产后抑郁 产妇母乳喂养效能 产后睡眠质量 Pearson相关系数 0.258a 0.543a 0.384a -0.225a P值 < 0.001 < 0.001 < 0.001 < 0.001 注：a表示在0.01级别(双尾)，相关性检验结果有意义。
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表 4 产后睡眠影响因素的多元线性回归分析
Table 4. Multiple linear regression analysis of influencing factors of postpartum sleep
变量 未标准化β值 sx值 标准化β值 t值 P值 常量 3.304 0.767 4.309 < 0.001 孕期睡眠 0.528 0.052 0.466 10.242 < 0.001 产后抑郁 0.120 0.032 0.184 3.812 < 0.001 产妇母乳喂养效能 -0.030 0.012 -0.114 -2.522 0.012 注：因变量为产后睡眠，预测变量：孕期睡眠，产后抑郁，产时母乳喂养效能；模型排除了孕期焦虑抑郁、民族、计划妊娠、新生儿出生后转科4个因素。
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