【作者】 陈晨；

【导师】 张秀敏；

【作者基本信息】 吉林大学 ， 公共卫生硕士（专业学位）， 2022， 硕士

【摘要】 目的:本研究通过调查孕晚期妇女抑郁现状,并从个人基本特征、孕产特征、行为生活方式、自评健康状况、妊娠压力、家庭关怀等角度探讨抑郁症状的影响因素,为提出针对性的预防和减少抑郁症状的措施提供科学依据。方法:本研究选取沈阳市某三级妇产专科医院九个产科病房住院待产36周以上妇女647人为调查对象。采用病例信息搜集和问卷调查法对研究对象进行调查。通过查阅住院患者电子病例信息搜集调查对象孕产特征,通过问卷调查了解调查对象的个人基本特征、行为生活方式、自评健康状况、抑郁症状、妊娠压力、家庭功能等。采用Epidata 3.1建立数据库并进行数据录入,应用IBM SPSS 24.0进行数据处理和统计分析。结果:1.沈阳市孕晚期妇女抑郁症状检出率为22.9%。2.单因素分析结果显示,居住地、家庭人均月收入(元)、兴趣爱好、是否每天吃早餐、是否荤素搭配饮食、孕期是否注意减少家用电器或手机/电脑辐射、自评健康状况、健康变化情况、妊娠压力、家庭功能是孕晚期孕妇抑郁症状的影响因素(P<0.05)。3.多因素分析中,在模型1、模型2、模型3、模型4、模型5中依次纳入人口学因素、行为生活方式因素、健康状况因素、妊娠压力因素、家庭功能因素。最终结果显示居住地在城市的孕晚期妇女抑郁症状的可能性是居住地在农村的2.761倍(95%CI:1.124-6.782);家庭人均月收入(元)在5001-7000、≤5000者抑郁症状的可能性分别是家庭人均月收入(元)≥10001者的2.930倍(95%CI:1.425-6.025)、2.085倍(95%CI:1.073-4.052);兴趣爱好一般/不广泛者抑郁症状的可能性是爱好广泛者的2.058倍(95%CI:1.097-3.858);妊娠压力轻度、中/重度者抑郁症状的可能性分别是无妊娠压力者的3.839倍(95%CI:1.157-12.739)、22.897倍(95%CI:6.431-81.514);家庭功能差者抑郁症状的可能性是家庭功能好者的2.060倍(95%CI:1.333-3.181)。每天吃早餐情况、是否荤素搭配饮食、孕期是否注意减少家用电器或手机/电脑辐射、自评健康状况、健康变化情况的调查对象抑郁症状检出率差异无统计学意义。结论:1.沈阳市孕晚期妇女抑郁症状检出率较高,孕妇抑郁状况应得到重视。2.经常所在地、家庭经济状况、兴趣爱好、妊娠压力、家庭功能是孕晚期妇女抑郁症状的独立影响因素。居住地在城市、家庭经济状况较差、妊娠压力较大是孕晚期妇女抑郁症状的危险因素。兴趣爱好广泛、家庭功能良好是孕晚期妇女抑郁症状的保护因素。3.通过个人、家庭、社会的共同努力,培养广泛的兴趣爱好、提高家庭功能、降低孕期压力,有利于预防和减少孕晚期妇女抑郁症状。更多还原

【Abstract】 Objective:This study was to understand the status of depressive symptoms among late pregnancy women through surveys,and to explore the influencing factors of depressive symptoms from the perspectives of personal characteristics,behavioral lifestyles,maternity characteristics,self-rated health status,pregnancy stress scale,and family care index,in order to prevent and reduce depressive symptoms of late pregnancy women.Methods:This study is based on a total of 647 women pregnancy over 36 weeks from nine obstetric wards of a tertiary obstetrics and gynecology hospital in Shenyang.The investigation was completed through case information collection and questionnaire survey.Information about maternity characteristics was collected by reviewing electronic medical record;the content of the questionnaire included personal characteristics,behaviors lifestyles,self-rated health status,depressive symptoms,pregnancy stress scale,family care index.Epidata 3.1 was used for database establishment and data input.IBM SPSS 24.0 was used for processing and analyzing.Results:1.The prevalence of depressive symptoms among late pregnant women was 22.9%in Shenyang.2.According to univariate analysis showed that residence place,family per capita monthly income(yuan),hobbies,whether to have breakfast every day,whether meat and vegetable diet,whether attention is paid to reducing the radiation of household appliances or mobile phones/computers during pregnancy,self-rated health status,health changes,pregnancy stress and family function were influence factors of depression symptoms in the third trimester(P<0.05).3.In multivariate analysis,Model 1,Model 2,Model 3,Model 4 and Model 5 in turn into personal characteristics,behaviors lifestyles,self-rated health status,pregnancy stress scale,family care index respectively.The final results showed that late pregnant women who lived in urban areas was 2.761 times(95%CI: 1.124-6.872)more likely to have depressive symptoms than that who lived in rural areas.The risk of depressive symptoms in participants whose family per capita monthly income(yuan)of5001-7000 and ≤5000 were 2.930 times(95% CI: 1.425-6.025)and 2.085 times(95%CI: 1.073-4.052)than participants whose family per capita income(yuan)of ≥10001respectively.The risk of depressive symptoms in participants who had ordinary/not extensive interests was 2.058 times(95% CI: 1.097-3.858)than those had extensive interests;the risk of depressive symptoms in participants with moderate / severe and mild pregnancy stress were 3.839 times(95% CI: 1.157-12.739)and 22.897 times(95%CI: 6.431-81.514)than those without pregnancy stress respectively;the risk of depressive symptoms in participants with poor family function was 2.060 times(95%CI: 1.333 ～ 3.181)than those with good family function.There was no significant difference in the detection rate of depressive symptoms among the subjects who ate breakfast every day,whether they ate meat and vegetable diet,whether they paid attention to reduce radiation from household appliances or mobile phones/computers during pregnancy,self-rated health status and health changes.Conclusions:1.The detection rate of depressive symptoms among late pregnancy women is high in Shenyang City and depressive symptoms of pregnancy women requires more attention.2.Frequent location,family economic status,hobbies,pregnancy pressure and family function are independent influencing factors of depressive symptoms in women in the third trimester.Residence in urban area,poor family economic status and increased stress in pregnancy are risk factors for depressive symptoms in women in the third trimester.A wide range of hobbies and good family functions are protective factors for depressive symptoms in women in the third trimester.3.The prevention and reduction in occurrence of depression symptoms in late pregnancy women benefits from developing wide range of hobbies,improving family function,reducing stress during pregnancy.This requires the joint effort of individuals,families and society.更多还原