产前抑郁在孕期运动与分娩恐惧之间的中介效应  

The mediating effect of antenataldepression betweenexercise and fear of childbirth during pregnancy

作　　者：金懿 刘诗迪 王旭[1,2] 李阳美 俞丽丽 雷迅 范尧[1,2] JIN Yi;LIU Shi-di;WANG Xu;LI Yang-mei;YU Li-li;LEI Xun;FAN Yao(School of Public Health,Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学公共卫生学院,重庆400016 [2]医学与社会发展研究中心,重庆400016 [3]重庆医科大学附属第三医院妇产中心,重庆401120

出　　处：《中国健康教育》2022年第11期990-995,共6页Chinese Journal of Health Education

基　　金：重庆医科大学附属第三医院护理骨干科研资助计划(KY08044);重庆医科大学公共卫生与管理学院“公卫菁英”计划资助项目(GWJY2021018)

摘　　要：目的探讨产前抑郁在孕期运动与分娩恐惧之间的中介效应。方法采用中文版孕期身体活动问卷(PPAQ)、患者健康问卷抑郁量表(PHQ-9)、分娩态度问卷(CAQ)对845例孕中晚期孕妇进行调查,运用R version 4.0.5构建结构方程模型,并分析三者之间的中介效应。结果孕妇运动达标率为40.7%,抑郁阳性率为6.5%,分娩恐惧发生率为58.3%。孕中期孕妇中孕期运动和产前抑郁呈显著负相关(点估计=-0.109,P=0.028),产前抑郁和分娩恐惧呈显著正相关(点估计=0.746,P<0.001),产前抑郁在孕期运动和分娩恐惧之间的中介效应显著(点估计=-0.081,P=0.031);而孕晚期孕妇中孕期运动与产前抑郁和分娩恐惧之间的直接效应均不显著(P>0.05),产前抑郁和分娩恐惧呈显著正相关(点估计=0.792,P<0.001),产前抑郁在孕期运动和分娩恐惧之间的中介效应不显著(点估计=-0.016,P=0.472)。结论孕中期孕妇中,产前抑郁在运动与分娩恐惧之间起中介作用,妊娠期妇女可通过增加运动的方式减少抑郁的发生率,进而减少对分娩恐惧的关注,改善分娩体验。Objective To explore the mediating effect of antenatal depression between exercise and fear of childbirth during pregnancy.Methods The Chinese version of the Pregnancy Physical Activity Questionnaire,Patient Health Questionnaire-9,and Childbirth Attitudes Questionnaires were used to investigate 845 pregnant women in mid-to-late pregnancy,and R version 4.0.5 was used to construct and test the structural equation model.Results The compliance rate of exercise during pregnancy was 40.7%,the positive rate of depression was 6.5%,and the occurrence rate of childbirth fear was 58.3%.There was a significant negative association between exercise during pregnancy and antenatal depression in mid-pregnancy pregnant women(point estimation=-0.109,P=0.028),antenatal depression and fear of childbirth were significantly positively correlated(point estimation=0.746,P<0.001),and a significant mediating effect of antenatal depression between exercise during pregnancy and fear of childbirth(point estimation=-0.081,P=0.031).The direct effect between exercise during pregnancy during late-pregnancy and both antenatal depression and fear of childbirth was not significant(P>0.05),antenatal depression and fear of childbirth were significantly positively correlated(point estimation=0.792,P<0.001),and the mediating effect of antenatal depression between exercise during pregnancy and fear of childbirth was not significant(point estimation=-0.016,P=0.472).Conclusion Antenatal depression mediates the relationship between exercise during pregnancy and fear of childbirth among mid-pregnancy pregnant women,and women in pregnancy could reduce the incidence of depression by increasing exercise,which in turn reduces the focus on the fear of childbirth and improves the childbirth experience.

关 键 词：孕期运动 产前抑郁 分娩恐惧 结构方程模型 

分 类 号：R473.71[医药卫生—护理学]