医源性多胎妊娠患者的焦虑抑郁现状及影响因素分析  

Analysis on the status and influencing factors of anxiety and depression in Iatrogenic multiple pregnancy women

作　　者：罗桂英[1] 王春艳[1] 魏兆莲[1] 丛林[1] 潘发明[2] LUO Gui-ying;WANG Chun-yan;WEI Zhao-lian;CONG Lin;PAN Fa-ming(Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China;Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China)

机构地区：[1]安徽医科大学第一附属医院生殖医学中心,安徽合肥230022 [2]安徽医科大学公共卫生学院流行病与卫生统计学系,安徽合肥230032

出　　处：《中华疾病控制杂志》2018年第4期374-379,共6页Chinese Journal of Disease Control & Prevention

基　　金：国家重点研发计划(2016YFC1000204)

摘　　要：目的调查医源性多胎妊娠患者的焦虑、抑郁现状,并分析影响其心理健康的相关因素。方法选取本市某医院生殖中心体外授精-胚胎移植助孕获得多胎妊娠的患者进行调查,采用自编的一般情况调查表及焦虑自评量表(self rating anxiety scale,SAS)、ZUNG氏抑郁量表(self-rating depressive scale,SDS)来收集患者资料,用Epi Data 3.1、SPSS 16.0进行数据库的建立、数据的整理及统计分析。结果本研究共调查240例医源性多胎妊娠患者,按照患者不孕类型分为原发不孕和继发不孕两组,两组间在不孕原因方面,差异有统计学意义(X^2=7.871,P=0.049)。研究对象中焦虑检出率为47.50%、抑郁检出率为66.25%。多因素Logistic回归分析结果显示:继发不孕(OR=2.274,95%CI:1.312~3.941,P=0.003)和注重男孩(OR=4.591,95%CI:2.492~8.459,P<0.001)是影响SAS评分的危险因素;既往无疾病史(OR=0.248,95%CI:0.074~0.832,P=0.024)是SDS评分的保护因素,家庭人均月收入较高(OR=4.105,95%CI:1.204~14.004,P=0.024)、渴望生育男孩(OR=2.303,95%CI:1.161~4.568,P=0.017)是SDS评分的危险因素。结论继发不孕、渴望生育男孩是医源性多胎妊娠患者焦虑发生的危险因素;高收入水平、渴望生育男孩是抑郁发生的重要危险因素。Objective To investigate the status of anxiety and depression in iatrogenic muhiple pregnancy, and to analyze the relevant factorswhich affect their mental health. Methods The multiple pregnancy patients with IVF-ET （ in vitro fertilization-embryo transfer） were selected from a reproductivc center in Hefei, Anhui. And we collected the data with the self-designed General Situation Questionnaire, the pregnancy stress scale （SAS） and Self-rating depression scale （SDS） to evaluate the anxious and despondent status of the patients. Results A total of 240 patients with multiple preg- nancy from a reproductive center in Hefei were recruited. According to the patient＇ s infertility type, they were divided into two groups with primary infertility and secondary infertility, and the difference between the two groups in the cause of infer- tility was statistically significant （ Z2 = 7. 871, P = 0. 049 ）. The anxiety and depression detection rate was 47.50% and 66. 25% respectively. Multivariate regression analysis showed that SAS score was correlated with and secondary infertility （OR =2. 274, 95% CI： 1. 312-3. 941, P = 0. 003）, pay attention to the sex of the fetus（OR =4. 591, 95% CI：2. 492- 8. 459, P 〈 0. 001 ）. No family history of disease （ OR = 0. 248, 95 % CI：0. 074-0. 832, P = 0. 024）were protective factors of SDS scores. The average monthly income （OR = 4. 105,95 % CI：I. 204-14. 004, P = 0. 024）and pay attention to the sex of the fetus （ OR = 2. 303, 95% CI：1. 161-4. 568, P = 0. 017）was risk factor of SDS scores. Conclusions Secondary infertility and eagering to give birth with boys may be a risk factor of iatrogenic sexual anxiety in patients with multiple pregnancy. A high level of income, eagering to give birth with boys are important risk factors for depression.

关 键 词：医源性多胎妊娠 焦虑 抑郁 影响因素 

分 类 号：R714.23[医药卫生—妇产科学] R395.6[医药卫生—临床医学]