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目的通过对孕产妇的随访了解孕、产期焦虑、抑郁的发生情况,并进一步分析相关危险因素。方法符合入组及排除标准的满16孕周的孕妇307例,随访时间为产后2～3d,产后42d、3个月,予填写相关危险因素调查表和综合性医院焦虑/抑郁情绪量表(HAD量表),产后增加爱丁堡产后抑郁量表(EPDS量表)筛查产后抑郁。结果孕期(HAD量表)焦虑发生率为5.5%,抑郁发生率为4.9%;产后(EPDS量表)2～3d抑郁发生率为7.5%,产后42d为13.5%,产后3个月为9.8%。产后2～3dHAD与EPDS量表抑郁检出率的差异无显著性(P=0.345),但产后42d和产后3个月的差异有显著性(P=0.019,P=0.001);各时点两量表的内部一致性均较差。孕期焦虑对产后2～3d的抑郁具有预测意义,孕期抑郁对产后42d的抑郁具有预测意义。初潮年龄、担忧孩子患遗传性疾病是孕期焦虑情绪的主要危险因素,既往胎儿/婴儿死亡、营养和担忧孩子喂养是孕期抑郁情绪的主要危险因素。产后抢救、产后饮食、产前思想准备和产前洁癖是产后2～3d抑郁的主要危险因素,住房设备是产后42d抑郁的主要危险因素,住房环境、有无请保姆和有无烦恼事件是产后3个月抑郁的主要危险因素。结论孕、产期焦虑、抑郁情绪是客观存在的,产后不同时期抑郁发生率并不完全相同,且不同时期焦虑、抑郁的危险因素也不完全一致,孕期的不良情绪会直接导致产后抑郁的发生。故保健工作应在确认怀孕后及时开展。
Objective To understand the incidence of pregnancy, maternal anxiety and depression through follow-up of pregnant women and to further analyze the related risk factors. Methods A total of 307 pregnant women, who were enrolled and excluded, were enrolled in this study. The follow-up time was 2 to 3 days postpartum, 42 days and 3 months postpartum. The relevant risk factors questionnaire and general hospital anxiety / depression questionnaire HAD scale), Postpartum increase postpartum depression scale (EPDS scale) screening for postpartum depression. Results The prevalence of anxiety during pregnancy (HAD scale) was 5.5%, the incidence of depression was 4.9%; postpartum (EPDS scale) 2 ~ 3d depression rate was 7.5%, postpartum 42d 13.5%, postpartum 3 months 9.8% . There was no significant difference in the detection rate of depression between HAD and EPDS 2 ~ 3 days postpartum (P = 0.345), but there was significant difference between the 42 days postpartum and 3 months postpartum (P = 0.019, P = 0.001) The internal consistency of the scales is poor. Anxiety during pregnancy has a predictive value on depression of 2 to 3 days after delivery, and depression during pregnancy has a predictive value on the 42nd day after delivery. Age of menarche, worry about children with genetic disease is the main risk factor for anxiety during pregnancy, previous fetal / infant mortality, nutrition and worry about child feeding is the main risk factor for depression during pregnancy. Postpartum salvage, postnatal diet, prenatal thoughts and prenatal follow-up were the main risk factors of postpartum 2 ~ 3d depression. Housing equipment was the main risk factor for postpartum depression at 42 days. Housing environment, 3 months the main risk factors for depression. Conclusion The incidence of anxiety and depression in pregnancy and childbirth is objective. The incidence of depression in different periods of postpartum is not exactly the same, and the risk factors of anxiety and depression in different periods are not exactly the same. The negative emotions in pregnancy will directly lead to the occurrence of postpartum depression . Therefore, health care work should be carried out in a timely manner after confirmation of pregnancy.