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9 516例妊娠早期妇女焦虑和抑郁症状与孕产史的关系

邹鹏,  黄巧,  陈卿,  周妮娅,  杨桓,  周文正,  陈红燕,  何阳,  刘晋祎,  曹佳,  敖琳,  漆洪波

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文章导航 > 中华疾病控制杂志  > 2023 >  27(1): 65-69
邹鹏, 黄巧, 陈卿, 周妮娅, 杨桓, 周文正, 陈红燕, 何阳, 刘晋祎, 曹佳, 敖琳, 漆洪波. 9 516例妊娠早期妇女焦虑和抑郁症状与孕产史的关系[J]. 中华疾病控制杂志, 2023, 27(1): 65-69. doi: 10.16462/j.cnki.zhjbkz.2023.01.012
引用本文: 邹鹏, 黄巧, 陈卿, 周妮娅, 杨桓, 周文正, 陈红燕, 何阳, 刘晋祎, 曹佳, 敖琳, 漆洪波. 9 516例妊娠早期妇女焦虑和抑郁症状与孕产史的关系[J]. 中华疾病控制杂志, 2023, 27(1): 65-69. doi: 10.16462/j.cnki.zhjbkz.2023.01.012
shu
ZOU Peng, HUANG Qiao, CHEN Qing, ZHOU Ni-ya, YANG Huan, ZHOU Wen-zheng, CHEN Hong-yan, HE Yang, LIU Jin-yi, CAO Jia, AO Lin, QI Hong-bo. The associations of anxiety and depression symptoms with pregnancy history among 9 516 early pregnant women[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(1): 65-69. doi: 10.16462/j.cnki.zhjbkz.2023.01.012
Citation: ZOU Peng, HUANG Qiao, CHEN Qing, ZHOU Ni-ya, YANG Huan, ZHOU Wen-zheng, CHEN Hong-yan, HE Yang, LIU Jin-yi, CAO Jia, AO Lin, QI Hong-bo. The associations of anxiety and depression symptoms with pregnancy history among 9 516 early pregnant women[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(1): 65-69. doi: 10.16462/j.cnki.zhjbkz.2023.01.012
shu

9 516例妊娠早期妇女焦虑和抑郁症状与孕产史的关系

doi: 10.16462/j.cnki.zhjbkz.2023.01.012
  • 1.

    400000 重庆，陆军军医大学(第三军医大学)军事预防医学系毒理学研究所

  • 2.

    401120 重庆，重庆市妇幼保健院产科门诊

  • 3.

    401120 重庆，重庆市妇幼保健院质量管理科

  • 4.

    401120 重庆，重庆市妇幼保健院手术室

  • 5.

    401120 重庆，重庆市妇幼保健院院办公室

邹鹏和黄巧为共同第一作者
基金项目: 

国家自然科学基金 82130097

国家自然科学基金 82003429

详细信息
    通讯作者:

    漆洪波，E-mail：qihongbo728@163.com

    敖琳，E-mail：aolin117@163.com

  • 中图分类号: R395.6;R715.3

The associations of anxiety and depression symptoms with pregnancy history among 9 516 early pregnant women

  • 1.

    Institute of Toxicology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 400000, China

  • 2.

    Obstetrics Clinic, Chongqing Health Center for Women and Children, Chongqing 401120, China

  • 3.

    Quality Management Department, Chongqing Health Center for Women and Children, Chongqing 401120, China

  • 4.

    Operating Room, Chongqing Health Center for Women and Children, Chongqing 401120, China

  • 5.

    Administration Office, Chongqing Health Center for Women and Children, Chongqing 401120, China

ZOU Peng and HUANG Qiao contributed equally to this work
Funds: 

National Natural Science Foundation of China 82130097

National Natural Science Foundation of China 82003429

More Information

    摘要
  • 摘要:   目的  探讨孕产史对妊娠早期妇女焦虑和抑郁症状发生率的影响。  方法  采用广泛焦虑量表(generalized anxiety disorder-7 items, GAD-7)和患者健康问卷(patient health questionaire-9 items, PHQ-9)评测重庆市妇幼保健院产科门诊2020年2-10月建档的9 516例妊娠早期妇女焦虑和抑郁症状。单因素分析检测焦虑和抑郁症状的影响因素，logistics回归分析模型进一步分析孕产史对焦虑和抑郁症状发生率的影响。  结果  妊娠早期妇女焦虑和抑郁症状检出率分别为18.9%和47.5%。单因素分析显示年龄、孕前BMI、吸烟史、饮酒史、过敏史、产次和流产次数与焦虑和抑郁症状相关(均有P < 0.001)。校正混杂因素后，logistics回归分析模型分析显示相较于再产妇，初产妇焦虑症状的发生率增高(OR=1.16, 95% CI: 1.01~1.33, P= 0.031)；流产史增加焦虑(OR=1.26, 95% CI: 1.13~1.41, P < 0.001)和抑郁(OR=1.19, 95% CI: 1.09~1.29, P < 0.001)症状的发生风险。  结论  初次生产和流产史是妊娠早期妇女焦虑和抑郁症状的重要危险因素。
    Abstract:   Objective  To investigate the effect of pregnancy history on the incidence of depression and anxiety symptoms among early pregnant women.  Methods  A total of 9 516 early pregnant women were recruited from Obstetric Clinic of the Chongqing Maternal and Child Health Hospital during February 2020 to October 2020. Anxiety and depression symptoms were evaluated by Generalized Anxiety Disorder-7 items (GAD-7) and Patient Health Questionaire-9 items (PHQ-9), respectively. Univariate analyses were used to detect the influencing factors of anxiety and depression symptoms, and logistic analyses were used to evaluate the effect of pregnancy history on the incidence of depression and anxiety symptoms.  Results  The rates of anxiety and depression symptoms were 18.9% and 47.5% among early pregnant women, respectively. Results of univariate analyses indicated that age, BMI (before pregnancy), smoking history, alcohol drinking history, allergies, parity, and abortion number were related to anxiety and depression symptoms. After adjusting for confounders, logistic analyses showed that primipara had higher risk of anxiety symptoms than multipara (OR=1.16, 95% CI: 1.01-1.33, P=0.031). Abortion was associated with increased odds for anxiety (OR=1.26, 95% CI: 1.13-1.41, P < 0.001) and depression (OR=1.19, 95% CI: 1.09-1.29, P < 0.001) symptoms, respectively.  Conclusion  Our study suggested that primipara and abortion were important risk factors for depression and anxiety symptoms in early pregnant women.
    • HTML全文

  • 表  1  研究对象的人口学和心理状态特征

    Table  1.   Demographic and psychological characteristic of survey population

    变量 人数(n) [M(P25, P75)/n(%)]
    年龄(岁) 9 516 29.00(26.00, 32.00)
    孕前BMI(kg/m2) 9 503 20.70(19.15, 22.60)
    吸烟史 9 440 311(3.3)
    饮酒史 9 349 1 599(17.1)
    过敏史 9 516 739(7.8)
    初潮年龄(岁) 9 511 12.00(11.00, 13.00)
    月经周期(d) 9 514 29.00(29.00, 30.50)
    月经持续时间(d) 9 514 5.50(4.50, 6.50)
    产次(次) 9 516 0.00(0.00, 1.00)
    孕次(次) 9 516 2.00(1.00, 3.00)
    流产次数(次) 9 516 0.00(0.00, 1.00)
    GAD-7得分 9 516 1.00(0.00, 4.00)
    焦虑状态 9 516 1 794(18.9)
    PHQ-9得分 9 516 4.00(2.00, 7.00)
    抑郁状态 9 516 4 523(47.5)
    下载: 导出CSV

    表  2  一般资料在不同焦虑和抑郁状态孕妇间的分布差异[M(P25, P75)]

    Table  2.   Differences in the distribution of general information among pregnant women with or without anxiety and depression symptoms [M(P25, P75)]

    变量a 焦虑症状 抑郁症状
    无(n=7 722) 有(n=1 794) Z/χ2值b P值 无(n=4 993) 有(n=4 523) Z/χ2值b P值
    年龄(岁) 29.00（26.00, 32.00) 28.00（26.00, 31.00) -4.42 < 0.001 29.00（26.00, 32.00) 28.00（26.00, 31.00) -4.27 < 0.001
    孕前BMI(kg/m2) 20.72（19.20, 22.60) 20.70（19.10, 22.60) -0.85 0.395 20.83（19.23, 22.67) 20.64（19.13, 22.48) -4.10 < 0.001
    吸烟史[n(%)] 215（2.8) 96（5.4) 30.26 < 0.001 135（2.7) 176（3.9) 10.56 0.001
    饮酒史[n(%)] 1 221（16.0) 378（21.7) 32.04 < 0.001 754（15.3) 845（19.1) 23.62 < 0.001
    过敏史[n(%)] 556（7.2) 183（10.2) 18.30 < 0.001 321（6.4) 418（9.2) 26.21 < 0.001
    初潮年龄(岁) 12.00（11.00, 13.00) 12.00（11.00, 13.00) -0.72 0.473 12.00（11.00, 13.00) 12.00（11.00, 13.00) -1.24 0.216
    月经周期(d) 29.00（29.00, 30.50) 29.00（29.00, 31.00) -1.55 0.122 29.00（29.00, 30.50) 29.00（29.00, 31.00) -1.22 0.222
    月经持续时间(d) 5.50（4.50, 6.50) 5.50（4.50, 6.50) -0.68 0.500 5.50（4.50, 6.50) 5.50（4.50, 6.50) -0.95 0.340
    产次(次) 0.00（0.00, 1.00) 0.00（0.00, 0.00) -3.98 < 0.001 0.00（0.00, 1.00) 0.00（0.00, 1.00) -3.65 < 0.001
    孕次(次) 2.00（1.00, 3.00) 2.00（1.00, 3.00) -1.43 0.153 2.00（1.00, 3.00) 2.00（1.00, 3.00) -1.35 0.177
    流产次数(次) 0.00（0.00, 1.00) 1.00（0.00, 1.00) -3.50 < 0.001 0.00（0.00, 1.00) 1.00（0.00, 1.00) -3.18 < 0.001
    注：a所有连续变量数据以[M(P25, P75)]呈现；b统计量Z值和χ2值分别由Mann-Whitney U和χ2检验分析得出。
    下载: 导出CSV

    表  3  孕产史对妊娠早期妇女焦虑和抑郁症状影响的logistic回归分析模型

    Table  3.   Logistic regression analysis of the effects of pregnancy history on anxiety and depression symptoms among early pregnant women

    变量a 例数(n) 焦虑症状 抑郁症状
    OR(95% CI)值a P值 OR(95% CI)值b P值 OR(95% CI)值a P值 OR(95% CI)值b P值
    生产史
        有 2 721 1.00 1.00 1.00 1.00
        无 6 795 1.27(1.13~1.43) < 0.001 1.16(1.01~1.33) 0.031 1.18(1.08~1.29) < 0.001 1.09 (0.99~1.21) 0.096
    流产史
        无 4 843 1.00 1.00 1.00 1.00
        有 4 673 1.25(1.13~1.39) < 0.001 1.26(1.13~1.41) < 0.001 1.17(1.08~1.27) < 0.001 1.19(1.09~1.29) < 0.001
    注：a未校正混杂因素；b校正年龄、孕前BMI、吸烟史、饮酒史、过敏史和生产史。
    下载: 导出CSV

    表  4  流产次数对妊娠早期妇女焦虑和抑郁症状影响的logistics回归分析

    Table  4.   Logistic regression analysis of the effect of abortion number on anxiety and depression symptoms among early pregnant women

    流产次数(次) n 焦虑症状 抑郁症状
    OR(95% CI)值a P值 OR(95% CI)值a P值
    0 4 843 1.00 1.00
    1 2 631 1.20(1.06~1.36) 0.005 1.14(1.03~1.26) 0.009
    2 1 264 1.14(1.05~1.24) 0.002 1.08(1.01~1.15) 0.026
    ≥3 778 1.13(1.06~1.22) 0.001 1.11(1.05~1.18) 0.000
    注：a校正年龄、孕前BMI、吸烟史、饮酒史、过敏史和生产史。
    下载: 导出CSV
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