二胎母亲孕产期心理健康及其影响因素调查研究  

Investigation on mental health of second-born mothers during pregnancy and after delivery and its influencing factors

作　　者：蔺华利[1] 陆誉宁 曹引丽 米阳 董晋 申宇昕 李超[1] LIN Huali;LU Yuning;CAO Yinli;MI Yang;DONG Jin;SHEN Yuxi;LI Chao(Xi’an Mental Health Center,Xi’an 710061,China)

机构地区：[1]西安市精神卫生中心,陕西西安710100 [2]陕西中医药大学,陕西咸阳712046 [3]西北妇女儿童医院,陕西西安710003 [4]四川大学,四川成都610041

出　　处：《陕西医学杂志》2021年第4期503-506,共4页Shaanxi Medical Journal

基　　金：西安市科技计划项目[201805099YX7SF(3),20YXYJ0007(5)]。

摘　　要：目的:调查二胎母亲孕产期心理健康状况,探讨其影响因素,并分析其对新生儿气质类型及神经行为的影响。方法:采用自制影响因素问卷、Zung焦虑自评量表(SAS)、Zung抑郁自评量表(SDS)、爱丁堡产后抑郁量表(EPDS)对238例二胎孕妇在孕12周、24周、38周、产后第7天和产后第42天共5个时间节点纵向随访调查,采用小婴儿气质问卷、新生儿神经行为测定(NBNA)对新生儿进行调查。结果:①孕12周、24周、38周、产后第7天和产后第42天5个时间节点二胎母亲焦虑的检出率依次为11.34%、4.62%、11.76%、11.35%、7.14%,抑郁检出率依次为4.20%、1.26%、14.71%、13.03%、15.13%。②二胎母亲孕12周抑郁情绪对产后第7天抑郁的产生有影响(P<0.01);孕24周焦虑情绪对产后第42天焦虑的出现有影响(P<0.01)。③影响二胎母亲孕产期焦虑、抑郁的因素有头胎性别、家庭月收入、头胎健康状况、性别期待、担心喂养困难、饮食欠佳、担心养育孩子经济问题、对婆媳关系是否感到满意、是否担心头胎对二胎的态度、高危年龄等因素。④二胎母亲孕38周抑郁与小婴儿气质类型呈正相关(r=0.178),孕24周抑郁症状的发生与新生儿神经行为发育呈负相关(r=-0.282)。结论:①二胎母亲孕38周焦虑症状的检出率最高,抑郁症状的发生以产后第42天最高;②二胎母亲孕期3个阶段及产后2个阶段焦虑、抑郁症状发生的影响因素包括高龄、头胎健康状况、担心养育孩子经济问题、担心头胎对二胎的态度、对胎儿的性别期待等;③二胎母亲孕期抑郁症状对婴儿气质类型、新生儿神经行为发育有影响。Objective:To investigate the mental health of second-born mothers during pregnancy and after delivery,and to explore its influencing factors,and to analyze its influence on the temperament type and neurobehavior of newborns.Methods:The longitudinal follow-up survey of 238 second-born mothers was conducted by self-made influencing factor questionnaire,Zung Self-Rating Anxiety Scale(SAS),Zung Self-Rating Depression Scale(SDS),Edinburgh Postpartum Depression Scale(EPDS)at 12 weeks,24 weeks,38 weeks of gestation,and at the 7th day and 42nd day after delivery.The infant temperament questionnaire and neonatal neurobehavioral measurement(NBNA)were used to investigate the newborns.Results:The detection rates of anxiety for second-born mothers at 1.5 time points were 11.34%,4.62%,11.76%,11.35%,and 7.14%;the depression detection rates were 4.20%,1.26%,14.71%,13.03%,and 15.13%.Depression symptoms at 12 weeks of gestation had an effect on postpartum depression symptoms within 7 days(P<0.01).Anxiety symptoms at 24 weeks of gestation had an effect on anxiety symptoms at 42 days postpartum(P<0.01).Factors affecting the anxiety and depression of second-born mothers during pregnancy and after delivery were gender of the first child(OR=0.574,P=0.049),monthly family income(OR=12.057,P=0.036),health status of the first child(OR=6671.695,P=0.038),gender expectation(OR=18.162,P=0.049),worry about feeding difficulties(OR=184.681,P=0.013),poor diet(OR=422.685,P=0.010),worry about the financial problems of raising children(OR=0.006,P=0.015),whether satisfied with the relationship between mother-in-law and daughter-in-law(OR=0.079,P=0.049),whether worried about the attitude of the first child to the second child(OR=10.717,P=0.006),high-risk age(OR=0.018,P=0.000)and other factors.The depression of the second-born mother at 38 weeks of gestation was positively correlated with the temperament type of the baby(r=0.178),and the occurrence of depression symptoms at the 24th week of gestation was nega tively correlated with the neonatal neurobeh

关 键 词：二胎母亲 心理健康 影响因素 新生儿气质类型 新生儿神经行为 

分 类 号：R715.3[医药卫生—妇产科学]