上海孕产妇焦虑和抑郁现状及相关因素: 一项基于健康生态学模型的多中心研究

朱婷玉; 王子文; 熊晨菡; 沈晔; 顾婷婷; 金龙妹; 顾春怡; 王丽萍; 黄凌; 施云美; 吴建凤; 谢震宇; 蒋泓

doi:10.16462/j.cnki.zhjbkz.2024.01.008

文章导航 > 中华疾病控制杂志 > 2024 > 28(1): 46-55

朱婷玉, 王子文, 熊晨菡, 沈晔, 顾婷婷, 金龙妹, 顾春怡, 王丽萍, 黄凌, 施云美, 吴建凤, 谢震宇, 蒋泓. 上海孕产妇焦虑和抑郁现状及相关因素: 一项基于健康生态学模型的多中心研究[J]. 中华疾病控制杂志, 2024, 28(1): 46-55. doi: 10.16462/j.cnki.zhjbkz.2024.01.008

引用本文:

ZHU Tingyu, WANG Ziwen, XIONG Chenhan, SHEN Ye, GU Tingting, JIN Longmei, GU Chunyi, WANG Liping, HUANG Ling, SHI Yunmei, WU Jianfeng, XIE Zhenyu, JIANG Hong. The prevalence and related factors of maternal anxiety and depression in Shanghai: a multicenter study based on health ecology model[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(1): 46-55. doi: 10.16462/j.cnki.zhjbkz.2024.01.008

Citation:

ZHU Tingyu, WANG Ziwen, XIONG Chenhan, SHEN Ye, GU Tingting, JIN Longmei, GU Chunyi, WANG Liping, HUANG Ling, SHI Yunmei, WU Jianfeng, XIE Zhenyu, JIANG Hong. The prevalence and related factors of maternal anxiety and depression in Shanghai: a multicenter study based on health ecology model[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(1): 46-55. doi: 10.16462/j.cnki.zhjbkz.2024.01.008

引用本文:

Citation:

ZHU Tingyu, WANG Ziwen, XIONG Chenhan, SHEN Ye, GU Tingting, JIN Longmei, GU Chunyi, WANG Liping, HUANG Ling, SHI Yunmei, WU Jianfeng, XIE Zhenyu, JIANG Hong. The prevalence and related factors of maternal anxiety and depression in Shanghai: a multicenter study based on health ecology model[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(1): 46-55. doi: 10.16462/j.cnki.zhjbkz.2024.01.008

上海孕产妇焦虑和抑郁现状及相关因素: 一项基于健康生态学模型的多中心研究

doi: 10.16462/j.cnki.zhjbkz.2024.01.008

朱婷玉¹,
王子文²,
熊晨菡³,
沈晔³,
顾婷婷⁴,
金龙妹⁵,
顾春怡⁶,
王丽萍⁷,
黄凌⁸,
施云美⁹,
吴建凤¹⁰,
谢震宇¹¹,
蒋泓^1, ,

1.
复旦大学公共卫生学院妇幼与儿少卫生教研室, 国家卫生健康委员会卫生技术评估重点实验室，上海 200032
2.
上海市嘉定区妇幼保健院妇保科，上海 201821
3.
上海市浦东新区妇幼保健院孕产妇心理保健门诊，上海 201206
4.
上海市浦东新区妇幼保健中心妇女保健科，上海 201399
5.
上海市闵行区妇幼保健院妇女保健科，上海 201102
6.
复旦大学附属妇产科医院护理部，上海 200011
7.
中国福利会国际和平妇幼保健院健康教育科，上海 200030
8.
上海市第六人民医院妇产科，上海 200233
9.
上海市长宁区妇幼保健院妇幼所，上海 200050
10.
上海市奉贤区奉城医院妇产科，上海 201411
11.
上海市浦东新区妇幼保健院预防保健科，上海 201206

基金项目:

复旦大学公共卫生学院-嘉定区卫生健康委公共卫生高质量发展重点学科、重点专项 GWGZLXK-2023-04

上海市妇女联合会 Year 2022

上海市加强公共卫生体系建设三年行动计划(2023-2025年)重点学科 GWVI-11.1-32

上海市公共卫生体系建设三年行动计划学科带头人计划 GWV-10.2-XD10

详细信息

通讯作者:
蒋泓，E-mail: h_jiang@fudan.edu.cn

中图分类号: R173
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- HTML全文浏览量: 182
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- 被引次数: 0
出版历程
- 收稿日期: 2023-08-08
- 修回日期: 2023-10-24
- 网络出版日期: 2024-02-05
- 刊出日期: 2024-01-10

The prevalence and related factors of maternal anxiety and depression in Shanghai: a multicenter study based on health ecology model

1.
Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Key Laboratory of Health Technology Evaluation (National Health Commission), Shanghai 200032, China
2.
Department of Maternal Care, Shanghai Jiading District Maternal and Child Health Care Hospital, Shanghai 201821, China
3.
Maternal Mental Health Clinic, Maternal and Child Health Care Hospital of Shanghai Pudong New Area, Shanghai 201206, China
4.
Department of Maternal Health, Maternal and Child Health Care Center of Pudong New Area in Shanghai, Shanghai 201399, China
5.
Department of Maternal Health, Minhang District Maternal and Child Health Hospital, Shanghai 201102, China
6.
Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
7.
Department of Health Education, International Peace Maternal and Child Health Hospital, Shanghai 200030, China
8.
Department of Obstetrics and Gynecology, Shanghai Sixth People′s Hospital, Shanghai 200233, China
9.
Maternal and Child Health Centre, Changning Maternity and Infant Health Hospital, Shanghai 200050, China
10.
Department of Obstetrics and Gynecology, Fengxian District, Fengcheng Hospital, Shanghai 201411, China
11.
Department of Prevention and Health Care, Maternal and Child Health Care Hospital of Shanghai Pudong New Area, Shanghai 201206, China

Funds:

The Key Discipline and Project of High-Quality Development of Public Health of School of Public Health, Fudan University-Jiading District Health Commission GWGZLXK-2023-04

Shanghai Women′s Federation Year 2022

The Key Discipline Program of Three-Year Strengthening Public Health Action Plan (2023-2025) of Shanghai GWVI-11.1-32

Discipline Leader Program of Three-Year Public Health Action Plan of Shanghai GWV-10.2-XD10

More Information

Corresponding author: JIANG Hong, E-mail: h_jiang@fudan.edu.cn

摘要

摘要: 目的了解上海孕产妇焦虑和抑郁现状，并基于健康生态学模型系统分析其相关因素。方法采用多阶段分层抽样，于2022年11月―2023年4月在上海开展多中心、横断面调查。使用7项广泛性焦虑障碍量表和患者健康问卷抑郁量表评价上海孕期及产后妇女焦虑、抑郁症状检出现状，并基于健康生态学模型分析孕产期焦虑、抑郁症状的相关因素及其效应量。结果共收集到有效问卷1 941份，孕期891份，产后1 050份。孕期焦虑和抑郁症状检出率分别为19.5%(95% CI: 0.169~0.221)、30.4%(95% CI: 0.274~0.334)；产后焦虑和抑郁症状检出率分别为18.2%(95% CI: 0.159~0.205)、23.2%(95% CI: 0.207~0.258)。二分类logistic回归分析模型分析显示，处于孕早期、怀孕次数≥2次、有精神疾病史、孕期及产后有负性事件、身体活动较少、睡眠质量较差、性格内向、生活满意度低、社会支持程度低、孕产相关知识了解程度较差、孩子性别不符合期望、产后休养条件满意程度较低的孕产妇焦虑或抑郁症状检出风险增高(均P＜0.05)。结论上海孕产妇焦虑、抑郁症状检出率较高。焦虑、抑郁症状的影响因素是多维度的，产前和产后检查时可根据危险因素确定高危人群，开展有针对性的心理健康保健服务。
- 孕产妇 /
- 焦虑 /
- 抑郁 /
- 健康生态学模型 /
- 相关因素
Abstract: Objective To understand the prevalence of maternal anxiety and depression in Shanghai and to explore the factors associated with them based on the Health ecology model. Methods Multistage stratified sampling method was used. A multicenter, cross-sectional survey was conducted from November 2022 to April 2023 in Shanghai. Generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used to evaluate anxiety and depression symptoms of pregnant women. Related factors and their effect size were analyzed based on the health ecology model. Results A total of 1 941 valid questionnaires were collected. Among these subjects, 891 were during pregnancy and 1 050 were during postpartum. The detection rate of anxiety and depression during pregnancy were 19.5% (95% CI: 0.169-0.221) and 30.4% (95% CI: 0.274-0.334), respectively. The detection rate of postpartum anxiety and depression symptoms were 18.2% (95% CI: 0.159-0.205) and 23.2% (95% CI: 0.207-0.258), respectively. The binary logistic regression model analysis showed that being in the first trimester, gravidity≥2, with history of mental illness, negative events during and after pregnancy, inactive physical activity, worse sleep quality, introversion, lower life satisfaction, less social support, poorer pregnancy related knowledge, unfavorite baby gender, and dissatisfaction with postpartum rest conditions were significantly associated with anxiety or depression symptoms during pregnancy or postpartum (all P < 0.05). Conclusions The detection rate of anxiety and depression in pregnant and postpartum women in Shanghai are relatively high. The factors associated with anxiety and depression are multidimensional. During prenatal and postpartum examinations, close attention should be paid to women with these risk factors and targeted mental health care services should be provided.
- Maternal /
- Anxiety /
- Depression /
- Health ecology model /
- Related factors

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表 1 孕期焦虑、抑郁相关因素的单因素分析与多因素logistic回归分析模型

Table 1. Univariate analysis and multivariable logistic regression analysis model of related factors of anxiety and depression during pregnancy

变量Variable	总体 ^② Population ^②	焦虑Anxiety						抑郁Depression
变量Variable	总体 ^② Population ^②	有 ^② Yes ^②	χ²值 value	P值 value	效应量 Effect size	aOR值value (95% CI)		有 ^② Yes ^②	χ²值 value	P值 value	效应量 Effect size	aOR值value (95% CI)
个人特质Personal traits
年龄组/岁Age group/years			2.623	0.453	0.054				10.180	0.017	0.107
＜25	57(6.4)	10(17.5)				1.000		23(40.4)				1.000
25~＜30	308(34.6)	52(16.9)				0.795(0.327~1.934)		88(28.6)				0.604(0.288~1.266)
30~＜35	376(42.2)	79(21.0)				0.900(0.369~2.193)		127(33.8)				0.712(0.337~1.504)
≥35	150(16.8)	33(22.0)				1.112(0.416~2.974)		33(22.0)				0.432(0.184~1.018)
孕期Trimester of pregnancy			4.293	0.117	0.069				1.647	0.439	0.043
孕早期First trimester	228(25.6)	44(19.3)				1.000		77(33.8)				1.000
孕中期Second trimester	288(32.3)	46(16.0)				0.647(0.381~1.098)		85(29.5)				0.708(0.450~1.112)
孕晚期Third trimester	375(42.1)	84(22.4)				0.982(0.599~1.612)		109(29.1)				0.596(0.382~0.930)
怀孕次数Number of pregnancies			9.410	0.002	0.103				1.573	0.210	0.042
1	436(48.9)	67(15.4)				1.000		124(28.4)				1.000
≥2	455(51.1)	107(23.5)				1.562(1.015~2.401)		147(32.3)				1.345(0.921~1.962)
既往妊娠并发症 Pregnancy complication history			1.843	0.175	0.045				0.017	0.897	0.004
无No	843(94.6)	161(19.1)				1.000		256(30.4)				1.000
有Yes	48(5.4)	13(27.1)				0.906(0.418~1.964)		15(31.3)				0.713(0.327~1.553)
妊娠计划内Pregnancy plan			0.080	0.777	0.009				1.077	0.299	0.035
否No	223(25.0)	45(20.2)				1.000		74(33.2)				1.000
是Yes	668(75.0)	129(19.3)				1.454(0.923~2.289)		197(29.5)				1.109(0.744~1.653)
精神疾病史 History of mental illness			2.852	0.091	0.057				7.811	0.005	0.094
否No	876(98.3)	168(19.2)				1.000		261(29.8)				1.000
是Yes	15(1.7)	6(40.0)				3.516(0.982~12.590)		10(66.7)				5.816(1.412~23.963)
睡眠质量Sleep			23.687	< 0.001	0.163				89.789	< 0.001	0.317
非常好Very good	89(10.0)	7(7.9)				1.000		11(12.4)				1.000
好Good	283(31.8)	42(14.8)				2.211(0.836~5.848)		50(17.7)				1.568(0.701~3.508)
一般General	427(47.9)	95(22.2)				3.191(1.233~8.261)		151(35.4)				3.488(1.606~7.577)
不好/非常不好 Poor/Very poor	92(10.3)	30(32.6)				4.130(1.452~11.748)		59(64.1)				11.944(4.895~29.144)
个体的行为生活方式及心理特征 Behavior and lifestyles and psychologicalcharacteristics
身体活动Physical activity			4.628	0.328	0.072				13.769	0.008	0.124
从不/每周＜1 d Never/Less than 1 day per week	356(40.0)	77(21.6)				1.000		130(36.5)				1.000
每周1~2 d 1-2 day per week	247(27.7)	45(18.2)				0.791(0.488~1.282)		67(27.1)				0.623(0.407~0.954)
每周3~4 d 3-4 day per week	148(16.6)	31(21.0)				0.927(0.539~1.594)		41(27.7)				0.713(0.432~1.177)
每周5~6 d 5-6 day per week	62(7.0)	12(19.4)				0.682(0.302~1.539)		19(30.7)				0.735(0.364~1.483)
每天Everyday	78(8.8)	9(11.5)				0.472(0.202~1.106)		14(18.0)				0.425(0.204~0.883)
孕产相关知识 Maternity related knowledge			4.419	0.220	0.070				21.099	< 0.001	0.154
非常了解Very familiar	58(6.5)	9(15.5)				1.000		6(10.3)				1.000
较为了解Relatively familiar	269(30.2)	56(20.8)				1.841(0.699~4.847)		67(24.9)				3.887(1.348~11.208)
一般General	376(42.2)	81(21.5)				1.643(0.630~4.285)		129(34.3)				5.319(1.869~15.137)
不太了解/非常不了解 Relatively unfamiliar/ Very unfamiliar	188(21.1)	28(14.9)				0.811(0.288~2.284)		69(36.7)				4.409(1.491~13.032)
艾森克内外向分量表^① Score of Eysenck personality questionnaire ^①	9(6，11)	8(5，10)		< 0.001	0.389	0.927(0.869~0.990)		8(5，10)		< 0.001	0.410	0.947(0.892~1.005)
生活满意度 Score of satisfaction with life scale	26(22，30)	23(20，27)		< 0.001	0.319	0.934(0.901~0.970)		24(20，28)		< 0.001	0.328	0.935(0.903~0.967)
家庭和社区的人际网络 Interpersonal network of family and community
婚姻状况Marital status			0.009	0.924	0.003				1.870	0.171	0.046
在婚不分居Married	854(95.8)	167(19.6)				1.000		256(30.0)				1.000
分居/离婚/丧偶/未婚 Separated/Divorced/ Widowed /Unmarried	37(4.2)	7(18.9)				0.887(0.318~2.470)		15(40.5)				0.954(0.407~2.240)
孕期负性事件 Negative events during pregnancy			31.560	< 0.001	0.188				46.908	< 0.001	0.229
否No	753(84.5)	123(16.3)				1.000		195(25.9)				1.000
是Yes	138(15.5)	51(37.0)				1.925(1.216~3.049)		76(55.1)				2.607(1.670~4.070)
社会支持 ^① Score of social support rate scale ^①	43(37，48)	38(34，44)		< 0.001	0.336	0.948(0.920~0.976)		40(35，44)		< 0.001	0.340	0.962(0.937~0.988)
生活和工作条件 Living and working conditions
学历Education level			0.984	0.611	0.033				1.000	0.606	0.034
高中及以下 Senior high school or below	173(19.4)	30(17.3)				1.000		58(33.5)				1.000
大专/职大 Junior college/ Vocational university	193(21.7)	36(18.7)				1.691(0.891~3.208)		58(30.1)				1.353(0.775~2.363)
大学及以上University or above	525(58.9)	108(20.6)				1.763(0.971~3.200)		155(29.5)				1.444(0.860~2.425)
工作状况Working status			1.928	0.381	0.047				4.154	0.125	0.068
是Yes	538(60.4)	99(18.4)				1.000		155(28.8)				1.000
休假Maternity leave	176(19.8)	34(19.3)				0.920(0.553~1.529)		51(29.0)				1.043(0.658~1.653)
无职业Unemployed	177(19.9)	41(23.2)				1.528(0.909~2.569)		65(36.7)				1.386(0.866~2.219)
居住条件Living condition			22.325	< 0.001	0.158				19.976	< 0.001	0.150
非常满意Very satisfied	189(21.2)	23(12.2)				1.000		38(20.1)				1.000
满意Satisfied	453(50.8)	83(18.3)				1.118(0.613~2.039)		134(29.6)				1.033(0.617~1.730)
一般General	225(25.3)	57(25.3)				1.081(0.549~2.126)		90(40.0)				1.003(0.557~1.807)
不满意/非常不满意 Unsatisfied/Very unsatisfied	24(2.7)	11(45.8)				2.170(0.705~6.685)		9(37.5)				0.514(0.165~1.597)
自觉经济压力Economic pressure			37.243	< 0.001	0.204				26.786	< 0.001	0.173
完全没压力No pressure at all	36(4.0)	3(8.3)				1.000	6(16.7)				1.000
几乎没压力Almost no pressure	121(13.6)	17(14.0)				1.073(0.257~4.489)	26(21.5)				1.002(0.302~3.320)
一般General	523(58.7)	85(16.3)				1.018(0.258~4.017)	152(29.1)				1.034(0.333~3.217)
较有压力A little stressful	182(20.4)	55(30.2)				1.710(0.419~6.986)	69(37.9)				1.108(0.340~3.614)
非常有压力Very stressful	29(3.3)	14(48.3)				3.624(0.744~17.644)	18(62.1)				3.031(0.737~12.467)
当地、国家、全球的文化、政策环境 Local, national, and global culture and policy
孕妇学校参与度 Maternity school participation			3.532	0.473	0.063			8.952	0.062	0.100
全程参加Attend all courses	31(3.5)	6(19.4)				1.000	6(19.4)				1.000
参加大部分课程 Attend most courses	81(9.1)	17(21.0)				0.450(0.133~1.523)	19(23.5)				0.578(0.170~1.963)
参加一半课程 Attend half courses	43(4.8)	13(30.2)				1.074(0.301~3.835)	14(32.6)				1.014(0.278~3.693)
参加少部分课程 Attend a few courses	180(20.2)	34(18.9)				0.498(0.160~1.550)	45(25.0)				0.646(0.208~2.003)
未参加 Did not attend any courses	556(62.4)	104(18.7)				0.462(0.157~1.362)	187(33.6)				0.818(0.277~2.413)
注：①使用Mann-Whitney U检验；②以人数(占比/%)或M(P₂₅，P₇₅)表示。 Note: ① Mann-Whitney U test; ② Number of people (proportion/%) or M(P₂₅，P₇₅).

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表 2 产后焦虑、抑郁相关因素的单因素分析与多因素logistic回归分析模型分析

Table 2. Univariate analysis and multivariable logistic regression analysis model of related factors of anxiety and depression during postpartum

变量Variable	总体 ^② Population ^②	焦虑Anxiety						抑郁Depression
变量Variable	总体 ^② Population ^②	有 ^② Yes ^②	χ²值 value	P值 value	效应量 Effect size	aOR值value (95% CI)		有 ^② Yes ^②	χ²值 value	P值 value	效应量 Effect size	aOR值value (95% CI)
个人特质Personal traits
年龄组/岁Age group/years			1.252	0.741	0.035				5.266	0.153	0.071
＜25	53(5.0)	12(22.6)				1.000		11(20.8)				1.000
25~＜30	318(30.3)	61(19.2)				1.044(0.425~2.566)		88(27.7)				2.211(0.854~5.726)
30~＜35	461(43.9)	81(17.6)				1.093(0.439~2.717)		96(20.8)				1.555(0.593~4.082)
≥35	218(20.8)	37(17.0)				1.050(0.393~2.807)		49(22.5)				1.708(0.614~4.746)
产后时期/月Postpartum period/months			4.360	0.037	0.064				3.553	0.059	0.058
＜1	631(60.1)	102(16.16)				1.000		134(21.2)				1.000
1~2	419(39.9)	89(21.24)				1.374(0.942~2.004)		110(26.3)				1.218(0.843~1.759)
怀孕次数 Number of pregnancies			1.469	0.226	0.037				3.749	0.053	0.060
1	602(57.3)	117(19.4)				1.000		153(25.4)				1.000
≥2	448(42.7)	74(16.5)				0.701(0.454~1.083)		91(20.3)				0.627(0.412~0.954)
此次妊娠并发症 Pregnancy complication			0.882	0.348	0.029				0.420	0.517	0.020
否No	797(75.9)	150(18.8)				1.000		189(23.7)				1.000
是Yes	253(24.1)	41(16.2)				0.725(0.462~1.138)		55(21.7)				0.858(0.559~1.318)
分娩中疼痛程度 Pain level during delivery			12.147	0.007	0.108				9.401	0.024	0.095
完全不痛Completely painless	90(8.6)	9(10.0)				1.000		12(13.3)				1.000
不太痛Painless	87(8.3)	13(14.9)				1.024(0.363~2.890)		15(17.2)				1.078(0.397~2.927)
一般General	198(18.9)	26(13.1)				0.833(0.332~2.085)		43(21.7)				1.709(0.737~3.962)
较痛/非常痛 Painful/Very painful	675(64.3)	143(21.2)				1.541(0.691~3.435)		174(25.8)				1.821(0.856~3.875)
此次分娩孩子健康状况 Health status of offspring			4.515	0.034	0.066				1.674	0.196	0.040
健康Health	936(89.1)	162(17.3)				1.000		212(22.7)				1.000
疾病Disease	114(10.9)	29(25.4)				1.188(0.683~2.067)		32(28.1)				0.830(0.473~1.457)
妊娠计划内Pregnancy plan			3.383	0.066	0.057				7.228	0.007	0.083
否No	208(19.8)	47(22.6)				1.000		63(30.3)				1.000
是Yes	842(80.2)	144(17.1)				0.959(0.605~1.523)		181(21.5)				0.768(0.493~1.196)
个人特质Personal traits
精神疾病史 History of mental illness			6.172	0.013	0.077				3.645	0.056	0.059
否No	1 041(99.1)	186(17.9)				1.000		239(23.0)				1.000
是Yes	9(0.9)	5(55.6)				7.829(1.683~36.424)		5(55.6)				7.053(1.400~35.530)
睡眠质量Sleep			60.682	< 0.001	0.240				131.243	< 0.001	0.354
非常好Very good	99(9.4)	4(4.0)				1.000		7(7.1)				1.000
好Good	293(27.9)	28(9.6)				1.622(0.509~5.165)		23(7.8)				0.635(0.233~1.725)
一般General	502(47.8)	104(20.7)				3.177(1.037~9.731)		132(26.3)				2.553(1.012~6.442)
不好/非常不好Poor/Very poor	156(14.9)	55(35.3)				3.452(1.071~11.128)		82(52.6)				4.220(1.593~11.176)
个体的行为生活方式及心理特征 Behavior and lifestyles and psychological characteristics
身体活动Physical activity			4.249	0.514	0.064				16.951	0.005	0.127
从不Never	128(12.2)	28(21.9)				1.000		40(31.3)				1.000
每周＜1 d Less than 1 day per week	204(19.4)	37(18.1)				0.916(0.479~1.752)		54(26.5)				0.870(0.477~1.586)
每周1~2 d 1-2 days per week	300(28.6)	61(20.3)				1.171(0.639~2.146)		70(23.3)				0.752(0.422~1.338)
每周3~4 d 3-4 days per week	200(19.0)	32(16.0)				0.923(0.475~1.795)		48(24.0)				1.002(0.546~1.839)
每周5~6 d 5-6 days per week	92(8.8)	15(16.3)				0.948(0.423~2.128)		18(19.4)				0.706(0.328~1.519)
每天Everyday	126(12.0)	18(14.3)				0.935(0.427~2.049)		14(11.1)				0.323(0.140~0.747)
孕产相关知识 Maternity related knowledge			56.475	< 0.001	0.232				52.071	< 0.001	0.223
非常了解Very familiar	122(11.6)	8(6.6)				1.000		14(11.5)				1.000
较为了解Relatively familiar	497(47.3)	65(13.1)				1.603(0.685~3.754)		84(16.9)				1.167(0.558~2.444)
一般General	380(36.2)	95(25.0)				2.748(1.171~6.446)		123(32.4)				1.698(0.811~3.557)
不太了解/非常不了解 Relatively unfamiliar/ Very unfamiliar	51(4.9)	23(45.1)				5.832(2.008~16.941)		23(45.1)				2.005(0.717~5.605)
艾森克内外向分量表^① Score of Eysenck personality questionnaire ^①	8(5，10)	7(3，9)		< 0.001	0.363	0.928(0.877~0.981)		6(3，9)		< 0.001	0.327	0.895(0.848~0.945)
生活满意度 Score of satisfaction with life scale	26(21，30)	21(19，25)		< 0.001	0.284	0.948(0.914~0.982)		22(20，25)		< 0.001	0.267	0.944(0.912~0.977)
家庭和社区的人际网络 Interpersonal network of family and community
婚姻状况Marital status			0.019	0.889	0.004				0.032	0.858	0.006
在婚不分居Married	1 032(98.3)	187(18.1)				1.000		239(23.2)				1.000
分居/离婚/丧偶/未婚 Separated/Divorced/ Widowed /Unmarried	18(1.7)	4(22.2)				1.042(0.283~3.828)		5(27.8)				1.295(0.349~4.800)
怀孕后负性事件 Negative events since pregnancy			39.145	< 0.001	0.193				38.184	< 0.001	0.191
否No	914(87.0)	140(15.3)				1.000		184(20.1)				1.000
是Yes	136(13.0)	51(37.5)				1.789(1.095~2.921)		60(44.1)				1.659(1.014~2.715)
社会支持_实际获得 ^① Score of postpartum support questionnaire ^①	188(163，215)	170(140，198)		< 0.001	0.326	0.994(0.989~1.000)		167(142，191)		< 0.001	0.301	0.991(0.985~0.996)
生活和工作条件 Living and working conditions
学历Education level			4.341	0.114	0.064				0.304	0.859	0.017
高中及以下 Senior high school or below	149(14.2)	33(22.1)				1.000		33(22.1)				1.000
大专/职大 Junior college/ Vocational university	228(21.7)	32(14.0)				0.528(0.273~1.019)		51(22.4)				1.057(0.553~2.021)
大学及以上University or above	673(64.1)	126(18.7)				0.699(0.378~1.294)		160(23.8)				1.003(0.535~1.882)
工作状况Work status			2.499	0.287	0.049				1.128	0.569	0.033
产假Maternity leave	883(84.1)	158(17.9)				1.000	208(23.6)				1.000
返岗工作Returning to work	16(1.5)	1(6.3)				0.203(0.022~1.899)	2(12.5)				0.299(0.053~1.705)
无职业Unemployed	151(14.4)	32(21.2)				0.972(0.534~1.767)	34(22.5)				0.809(0.447~1.465)
自觉经济压力Economic pressure			27.085	< 0.001	0.161			50.649	< 0.001	0.220
完全没压力/几乎没压力 No pressure at all/ Almost no pressure	174(16.6)	13(7.5)				1.000	16(9.2)				1.000
一般General	582(55.4)	101(17.4)				1.089(0.533~2.224)	121(20.8)				0.926(0.475~1.807)
较有压力A little stressful	259(24.7)	66(25.5)				1.359(0.633~2.918)	92(35.5)				1.589(0.777~3.247)
非常有压力Very stressful	35(3.3)	11(31.4)				1.021(0.326~3.200)	15(42.9)				1.249(0.426~3.663)
产后休养条件满意度 Living condition			90.864	< 0.001	0.294			116.087	< 0.001	0.333
非常满意Very satisfied	237(22.6)	20(8.4)				1.000	21(8.9)				1.000
满意Satisfied	549(52.3)	73(13.3)				0.934(0.511~1.706)	101(18.4)				1.425(0.782~2.598)
一般General	245(23.3)	88(35.9)				1.839(0.952~3.550)	110(44.9)				2.633(1.365~5.080)
不满意/非常不满意 Unsatisfied/Very unsatisfied	19(1.8)	10(52.6)				1.848(0.541~6.320)	12(63.2)				2.292(0.621~8.457)
当地、国家、全球的文化、政策环境 Local, national and global culture and policy
孕妇学校参与度 Maternity school participation			0.709	0.950	0.026			1.717	0.788	0.040
全程参加 Attend all courses	110(10.5)	17(15.5)				1.000	22(20.0)				1.000
参加大部分课程 Attend most courses	149(14.2)	27(18.1)				1.091(0.507~2.348)	31(20.8)				0.923(0.438~1.946)
参加一半课程 Attend half courses	51(4.9)	9(17.6)				0.825(0.299~2.276)	11(21.6)				0.841(0.316~2.238)
参加少部分课程 Attend a few courses	171(16.3)	31(18.1)				0.731(0.341~1.571)	42(24.6)				0.881(0.423~1.832)
未参加 Did not attend any courses	569(54.2)	107(18.8)				0.588(0.301~1.149)	138(24.3)				0.684(0.359~1.305)
对孩子性别满意程度 Attitude towards children′s gender			18.786	< 0.001	0.134			17.362	< 0.001	0.129
满意Satisfie	737(70.2)	112(15.2)				1.000	148(20.1)				1.000
较满意Relatively satisfied	69(6.6)	23(33.3)				2.403(1.264~4.567)	27(39.1)				2.323(1.220~4.421)
无所谓/不太满意 General/Relatively satisfied	244(23.2)	56(23.0)				1.003(0.652~1.543)	69(28.3)				0.878(0.575~1.340)
注：①使用Mann-Whitney U检验；②以人数(占比/%)或M(P₂₅，P₇₅)表示。 Note: ① Mann-Whitney U test; ② Number of people (proportion/%) or M(P₂₅，P₇₅).

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参考文献(13)

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变量Variable	总体 ^② Population ^②	焦虑Anxiety						抑郁Depression
变量Variable	总体 ^② Population ^②	有 ^② Yes ^②	χ²值 value	P值 value	效应量 Effect size	aOR值value (95% CI)		有 ^② Yes ^②	χ²值 value	P值 value	效应量 Effect size	aOR值value (95% CI)
个人特质Personal traits
年龄组/岁Age group/years			2.623	0.453	0.054				10.180	0.017	0.107
＜25	57(6.4)	10(17.5)				1.000		23(40.4)				1.000
25~＜30	308(34.6)	52(16.9)				0.795(0.327~1.934)		88(28.6)				0.604(0.288~1.266)
30~＜35	376(42.2)	79(21.0)				0.900(0.369~2.193)		127(33.8)				0.712(0.337~1.504)
≥35	150(16.8)	33(22.0)				1.112(0.416~2.974)		33(22.0)				0.432(0.184~1.018)
孕期Trimester of pregnancy			4.293	0.117	0.069				1.647	0.439	0.043
孕早期First trimester	228(25.6)	44(19.3)				1.000		77(33.8)				1.000
孕中期Second trimester	288(32.3)	46(16.0)				0.647(0.381~1.098)		85(29.5)				0.708(0.450~1.112)
孕晚期Third trimester	375(42.1)	84(22.4)				0.982(0.599~1.612)		109(29.1)				0.596(0.382~0.930)
怀孕次数Number of pregnancies			9.410	0.002	0.103				1.573	0.210	0.042
1	436(48.9)	67(15.4)				1.000		124(28.4)				1.000
≥2	455(51.1)	107(23.5)				1.562(1.015~2.401)		147(32.3)				1.345(0.921~1.962)
既往妊娠并发症 Pregnancy complication history			1.843	0.175	0.045				0.017	0.897	0.004
无No	843(94.6)	161(19.1)				1.000		256(30.4)				1.000
有Yes	48(5.4)	13(27.1)				0.906(0.418~1.964)		15(31.3)				0.713(0.327~1.553)
妊娠计划内Pregnancy plan			0.080	0.777	0.009				1.077	0.299	0.035
否No	223(25.0)	45(20.2)				1.000		74(33.2)				1.000
是Yes	668(75.0)	129(19.3)				1.454(0.923~2.289)		197(29.5)				1.109(0.744~1.653)
精神疾病史 History of mental illness			2.852	0.091	0.057				7.811	0.005	0.094
否No	876(98.3)	168(19.2)				1.000		261(29.8)				1.000
是Yes	15(1.7)	6(40.0)				3.516(0.982~12.590)		10(66.7)				5.816(1.412~23.963)
睡眠质量Sleep			23.687	< 0.001	0.163				89.789	< 0.001	0.317
非常好Very good	89(10.0)	7(7.9)				1.000		11(12.4)				1.000
好Good	283(31.8)	42(14.8)				2.211(0.836~5.848)		50(17.7)				1.568(0.701~3.508)
一般General	427(47.9)	95(22.2)				3.191(1.233~8.261)		151(35.4)				3.488(1.606~7.577)
不好/非常不好 Poor/Very poor	92(10.3)	30(32.6)				4.130(1.452~11.748)		59(64.1)				11.944(4.895~29.144)
个体的行为生活方式及心理特征 Behavior and lifestyles and psychologicalcharacteristics
身体活动Physical activity			4.628	0.328	0.072				13.769	0.008	0.124
从不/每周＜1 d Never/Less than 1 day per week	356(40.0)	77(21.6)				1.000		130(36.5)				1.000
每周1~2 d 1-2 day per week	247(27.7)	45(18.2)				0.791(0.488~1.282)		67(27.1)				0.623(0.407~0.954)
每周3~4 d 3-4 day per week	148(16.6)	31(21.0)				0.927(0.539~1.594)		41(27.7)				0.713(0.432~1.177)
每周5~6 d 5-6 day per week	62(7.0)	12(19.4)				0.682(0.302~1.539)		19(30.7)				0.735(0.364~1.483)
每天Everyday	78(8.8)	9(11.5)				0.472(0.202~1.106)		14(18.0)				0.425(0.204~0.883)
孕产相关知识 Maternity related knowledge			4.419	0.220	0.070				21.099	< 0.001	0.154
非常了解Very familiar	58(6.5)	9(15.5)				1.000		6(10.3)				1.000
较为了解Relatively familiar	269(30.2)	56(20.8)				1.841(0.699~4.847)		67(24.9)				3.887(1.348~11.208)
一般General	376(42.2)	81(21.5)				1.643(0.630~4.285)		129(34.3)				5.319(1.869~15.137)
不太了解/非常不了解 Relatively unfamiliar/ Very unfamiliar	188(21.1)	28(14.9)				0.811(0.288~2.284)		69(36.7)				4.409(1.491~13.032)
艾森克内外向分量表^① Score of Eysenck personality questionnaire ^①	9(6，11)	8(5，10)		< 0.001	0.389	0.927(0.869~0.990)		8(5，10)		< 0.001	0.410	0.947(0.892~1.005)
生活满意度 Score of satisfaction with life scale	26(22，30)	23(20，27)		< 0.001	0.319	0.934(0.901~0.970)		24(20，28)		< 0.001	0.328	0.935(0.903~0.967)
家庭和社区的人际网络 Interpersonal network of family and community
婚姻状况Marital status			0.009	0.924	0.003				1.870	0.171	0.046
在婚不分居Married	854(95.8)	167(19.6)				1.000		256(30.0)				1.000
分居/离婚/丧偶/未婚 Separated/Divorced/ Widowed /Unmarried	37(4.2)	7(18.9)				0.887(0.318~2.470)		15(40.5)				0.954(0.407~2.240)
孕期负性事件 Negative events during pregnancy			31.560	< 0.001	0.188				46.908	< 0.001	0.229
否No	753(84.5)	123(16.3)				1.000		195(25.9)				1.000
是Yes	138(15.5)	51(37.0)				1.925(1.216~3.049)		76(55.1)				2.607(1.670~4.070)
社会支持 ^① Score of social support rate scale ^①	43(37，48)	38(34，44)		< 0.001	0.336	0.948(0.920~0.976)		40(35，44)		< 0.001	0.340	0.962(0.937~0.988)
生活和工作条件 Living and working conditions
学历Education level			0.984	0.611	0.033				1.000	0.606	0.034
高中及以下 Senior high school or below	173(19.4)	30(17.3)				1.000		58(33.5)				1.000
大专/职大 Junior college/ Vocational university	193(21.7)	36(18.7)				1.691(0.891~3.208)		58(30.1)				1.353(0.775~2.363)
大学及以上University or above	525(58.9)	108(20.6)				1.763(0.971~3.200)		155(29.5)				1.444(0.860~2.425)
工作状况Working status			1.928	0.381	0.047				4.154	0.125	0.068
是Yes	538(60.4)	99(18.4)				1.000		155(28.8)				1.000
休假Maternity leave	176(19.8)	34(19.3)				0.920(0.553~1.529)		51(29.0)				1.043(0.658~1.653)
无职业Unemployed	177(19.9)	41(23.2)				1.528(0.909~2.569)		65(36.7)				1.386(0.866~2.219)
居住条件Living condition			22.325	< 0.001	0.158				19.976	< 0.001	0.150
非常满意Very satisfied	189(21.2)	23(12.2)				1.000		38(20.1)				1.000
满意Satisfied	453(50.8)	83(18.3)				1.118(0.613~2.039)		134(29.6)				1.033(0.617~1.730)
一般General	225(25.3)	57(25.3)				1.081(0.549~2.126)		90(40.0)				1.003(0.557~1.807)
不满意/非常不满意 Unsatisfied/Very unsatisfied	24(2.7)	11(45.8)				2.170(0.705~6.685)		9(37.5)				0.514(0.165~1.597)
自觉经济压力Economic pressure			37.243	< 0.001	0.204				26.786	< 0.001	0.173
完全没压力No pressure at all	36(4.0)	3(8.3)				1.000	6(16.7)				1.000
几乎没压力Almost no pressure	121(13.6)	17(14.0)				1.073(0.257~4.489)	26(21.5)				1.002(0.302~3.320)
一般General	523(58.7)	85(16.3)				1.018(0.258~4.017)	152(29.1)				1.034(0.333~3.217)
较有压力A little stressful	182(20.4)	55(30.2)				1.710(0.419~6.986)	69(37.9)				1.108(0.340~3.614)
非常有压力Very stressful	29(3.3)	14(48.3)				3.624(0.744~17.644)	18(62.1)				3.031(0.737~12.467)
当地、国家、全球的文化、政策环境 Local, national, and global culture and policy
孕妇学校参与度 Maternity school participation			3.532	0.473	0.063			8.952	0.062	0.100
全程参加Attend all courses	31(3.5)	6(19.4)				1.000	6(19.4)				1.000
参加大部分课程 Attend most courses	81(9.1)	17(21.0)				0.450(0.133~1.523)	19(23.5)				0.578(0.170~1.963)
参加一半课程 Attend half courses	43(4.8)	13(30.2)				1.074(0.301~3.835)	14(32.6)				1.014(0.278~3.693)
参加少部分课程 Attend a few courses	180(20.2)	34(18.9)				0.498(0.160~1.550)	45(25.0)				0.646(0.208~2.003)
未参加 Did not attend any courses	556(62.4)	104(18.7)				0.462(0.157~1.362)	187(33.6)				0.818(0.277~2.413)
注：①使用Mann-Whitney U检验；②以人数(占比/%)或M(P₂₅，P₇₅)表示。 Note: ① Mann-Whitney U test; ② Number of people (proportion/%) or M(P₂₅，P₇₅).

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上海孕产妇焦虑和抑郁现状及相关因素: 一项基于健康生态学模型的多中心研究

doi: 10.16462/j.cnki.zhjbkz.2024.01.008

通讯作者:
蒋泓，E-mail: h_jiang@fudan.edu.cn

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The prevalence and related factors of maternal anxiety and depression in Shanghai: a multicenter study based on health ecology model

Corresponding author: JIANG Hong, E-mail: h_jiang@fudan.edu.cn

计量

目录

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上海孕产妇焦虑和抑郁现状及相关因素: 一项基于健康生态学模型的多中心研究

doi: 10.16462/j.cnki.zhjbkz.2024.01.008

通讯作者: 蒋泓，E-mail: h_jiang@fudan.edu.cn

计量

出版历程

The prevalence and related factors of maternal anxiety and depression in Shanghai: a multicenter study based on health ecology model

Corresponding author: JIANG Hong, E-mail: h_jiang@fudan.edu.cn

计量

出版历程

目录

通讯作者:
蒋泓，E-mail: h_jiang@fudan.edu.cn