产前焦虑情绪对胎儿血流循环及围产结局的影响  

Effect of prenatal anxiety on fetal hemodynamic circulation and perinatal outcome

作　　者：蔡东阁[1] 周妮[1] 赵晓桂[1] 王倩[1] 邬晋芳[1] 

机构地区：[1]西安交通大学第二附属医院妇产科,西安710004

出　　处：《山西医科大学学报》2015年第10期1016-1020,共5页Journal of Shanxi Medical University

摘　　要：目的调查孕妇产前的心理焦虑状况,探讨产前焦虑与胎儿脐血流循环及围产结局的相关性,为孕期心理保健与干预提供科学依据。方法采用焦虑状态-特质问卷对323名孕妇于37-40孕周时进行产前问卷调查,以多普勒超声脐血流仪测定脐血流S/D值、RI值,记录分娩方式,新生儿评分、出生体重,并检测脐动脉血中胎儿有核红细胞的含量,以问卷评分≥57分为界限,得分≥57分为焦虑组,得分<57分为对照组,采用χ2检验及t检验分析孕妇焦虑情绪对脐血流S/D、RI值、脐血中胎儿有核红细胞数量及围产结局之间的影响。结果调查中共获得有效问卷306份,有59位孕妇焦虑总分≥57分,孕妇焦虑症状的发生率为19.28%;焦虑组孕妇的脐血流S/D、RI值显著增高(P<0.05);焦虑组孕妇脐血中胎儿有核红细胞数量较对照组增高(P<0.05)。焦虑组孕妇的产时手术助产、新生儿低出生体重率较对照组显著增高,差异有统计学意义(P<0.05)。焦虑组新生儿窒息发生率较对照组高,但差异无统计学意义(P>0.05)。结论孕期焦虑情绪对胎儿发育有不利影响,可导致胎儿宫内慢性缺氧,增加产妇手术助产率,并可导致低出生体重发生风险增高。应重视孕期的负性生活事件和心理压力,加强宣教,缓解焦虑情绪,以利胎儿发育及正常分娩。Objective To investigate the prevalence of maternal anxiety and its relationship with fetal dynamic blood flow circulation and perinatal outcome during the pregnancy. Methods A total of 323 pregnant women with 37- 40 gestational weeks were recruited.Face to face interviews were conducted on these pregnant women. The state trait anxiety inventory（ STAI） was used to assess the maternal anxiety status. Ultrasound Doppler was used to measure the blood flow changes in maternal-fetal circulation. The delivery way,the birth weight,the Apgar score and the nucleated red blood cell count in umbilical cord blood were recorded. The subjects were divided into control group and anxiety group according to the scores of the state trait anxiety inventory. Statistical analysis was performed with Chi-square test and t test. Two-tailed P values 0. 05 were considered statistical significance. Results A total of 306 questionnaires were valid. Of them,59 pregnant women（ 19. 28%） showed high score of anxiety symptom（ STAI score≥57）. Pregnant women with high score of anxiety had higher umbilical artery S / D and RI values,and higher nucleated red blood cell count in the umbilical cord blood than those with low score（ P 〈0. 05）. Also,the rate of cesarean delivery and the incidence of low birth weight were significantly higher in anxiety group than in control group（ P〈 0. 05）. The incidence of neonatal asphyxia was higher in anxiety group than in control group,but there was no statistically significant difference between the two groups（ P 〉0. 05）. Conclusion The results suggest that the high maternal trait anxiety during pregnancy has an adverse effect on maternal-fetal circulation,which can reduce the fetal oxygenation,lead to hypoxia and increase the incidences of cesarean delivery and low birth weight.

关 键 词：产前焦虑 血流循环 围产结局 新生儿 

分 类 号：R749.72[医药卫生—神经病学与精神病学]