自然分娩与剖宫产产妇产后精神障碍及其相关因素分析  

Influencing factors of postpartum mental disorders in pregnant women with natural delivery and cesarean section

作　　者：张丽伟 刘晓利[2] 万玉莹 杨艳梅 张旭 刘晓涵 ZHANG Liwei;LIU Xiaoli;WAN Yuying(Department of Obstetrics and Gynecology,Shangqiu Fourth People's Hospital,Shangqiu 476100,China)

机构地区：[1]商丘市第四人民医院妇产科,商丘476100 [2]河南省中医院妇产科

出　　处：《国际精神病学杂志》2019年第4期717-720,共4页Journal Of International Psychiatry

摘　　要：目的研究自然分娩与剖宫产产妇产后精神障碍情况,分析导致产妇产后出现精神障碍的危险因素。方法选取我院2016年2月~2018年2月经剖宫产分娩产妇800例为观察组,抽取同期于我院自然分娩的1000例产妇为对照组,全部产妇在分娩出院后均接受6个月随访。对比两组产妇产后精神障碍发生率,分析产妇临床资料,找出导致产妇产后发生精神障碍的危险因素。结果剖宫产产妇与自然分娩产妇产后精神障碍发生率比较,差异无统计学意义(P>0.05);经二元logistic回归分析发现,年龄> 35岁、文化程度低、家庭人均收入低、无业、婆媳关系与夫妻关系差、产次> 3次、性格内向、有家族史、产后身体恢复不佳及性生活不和谐可能是产后精神障碍的共同因素;既往有剖宫产史、病前性格内向、妊娠期有合并症则是影响剖宫产产妇产后精神障碍的独立危险因素。结论无论何种分娩方式,产妇在产后均有精神障碍发生风险,临床应重视围产期护理,以降低产后精神障碍发生风险,提高产妇产后生活质量。Objective To investigate the postpartum mental disorders in pregnant women with natural delivery and cesarean section. And we further analyze the risk factors of causing postpartum mental disorders. Methods 800 pregnant women with cesarean section in the hospital from February 2016 to April 2018 were selected as observation group,and 1000 pregnant women with natural delivery were selected as control group at the same time. All pregnant women were given 6-month follow-up after discharge. The incidence of postpartum mental disorders in the pregnant women of two groups were compared. The clinical data of pregnant women were analyzed,and the risk factors of causing postpartum mental disorders were investigated. Results There was no statistical difference in the incidence of postpartum mental disorders between the pregnant women with natural delivery and cesarean section(P>0.05);According to bivariate logistic regression analysis,the factors such as aged>35,low education level,low family income per capita,unemployed,worse relationship between mother-in-law and daughter-in-law,worse spousal relationship,parity>3 times,introversion,having family history,poor postpartum recovery,disharmonious sexual life could be common factors of causing postpartum mental disorders;The cesarean section history,introversion before illness,pregnancy complications were independent risk factors of influencing postpartum mental disorders in the pregnant women with cesarean section. Conclusion Regardless of the mode of delivery,the pregnant women have risks of postpartum mental disorders. It is necessary to provide better perinatal nursing,so as to decrease the risks of postpartum mental disorders,and increase the postpartum living quality of pregnant women.

关 键 词：自然分娩 剖宫产 精神障碍 影响因素 

分 类 号：R749.2[医药卫生—神经病学与精神病学]