多囊卵巢综合征患者产后心理状态的临床分析  

Clinical analysis of mental health among postpartum women with polycystic ovary syndrome

作　　者：杨雨璇 陈文曦 从静 周文杰 吴洁 YANG Yu-xuan;CHEN Wen-xi;CONG Jing;ZHOU Wen-jie;WU Jie(First Affiliated Hospital of Nanjing Medical University,Jiangsu Provincial Hospital,Jiangsu Hospital of Maternal&Child Healthcare,Nanjing 210029)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院江苏省妇幼保健院妇女保健科,南京210029

出　　处：《生殖医学杂志》2022年第10期1334-1340,共7页Journal of Reproductive Medicine

基　　金：江苏省妇幼健康重点学科项目(FXK 201701)。

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者产后发生心理障碍的情况及可能的危险因素,为临床上预防、早期识别及干预提供一定的依据。方法选取2020年1月至2022年1月在江苏省妇幼保健院产后42 d门诊就诊且孕前诊断为PCOS的产妇为PCOS组(n=172),同期孕前月经正常且无卵巢多囊样改变及高雄激素血症的非PCOS女性为对照组(n=1145)。记录产妇年龄、婚龄、固定工作、受教育程度、孕产次等指标,应用症状自评量表(SCL-90)分析所有产妇产后心理健康状况,并采用二元Logistic回归进行影响因素分析。结果PCOS组与对照组产妇的年龄、婚龄、固定工作、受教育程度、孕次等均无显著差异(P>0.05),但PCOS组的产次显著低于对照组[(1.1±0.4)次vs.(1.2±0.4)次,P<0.01];PCOS组的SCL-90总分、阳性项目数及强迫、人际关系敏感、抑郁、焦虑、敌对、偏执六项因子的阳性率均显著高于对照组(P<0.05);纳入本次研究的产妇进一步分层为初产妇与经产妇,初产妇PCOS组SCL-90量表总分、阳性项目数及强迫、人际关系敏感、精神病性、抑郁、焦虑、敌对、恐怖、偏执八项因子得分均显著高于对照组(P<0.05),而在经产妇中两组间无显著差异(P>0.05);Logistic回归分析显示,婚龄长、孕前较高体质量指数(BMI)、受教育程度高、新生儿性别为女、新生儿健康是产妇心理健康的独立保护因素(P<0.05),而有性别期待为其独立危险因素(P<0.05)。结论PCOS患者产后发生诸如强迫、人际关系敏感、抑郁等心理健康问题的风险较高,尤其是初产妇,临床医生与家庭应重视并给予更多关注。Objective:To evaluate the psychological disorders and possible risk factors in patients with polycystic ovary syndrome(PCOS)after delivery,and to provide some basis for clinical prevention,early identification and intervention.Methods:The women who visited the outpatient department of Jiangsu Hospital of Maternal&Child Healthcare 42 days after delivery and diagnosed with PCOS before pregnancy from January 2020 to January 2022 were selected as PCOS group(n=172).The postpartum women with regular menstrual cycle before pregnancy and without PCOS were selected as control group(n=1145).The maternal age,years of marriage,occupation,education level,pregnancy and childbirth were recorded,and the mental health status of all postpartum women was analyzed with Symptom Checklist-90(SCL-90).Besides,Logistic regression analysis was used to explore the potential influencing factors.Results:There were no significant differences in age,years of marriage,occupation,educational background and gravidity between the PCOS group and control group(P>0.05).However,parity of PCOS group was significantly lower than control group[(1.1±0.4)vs.(1.2±0.4),P<0.01].The total score of SCL-90,the number of positive items and the positive rate of six factors of obsession-compulsion,interpersonal sensitivity,depression,anxiety,hostility and paranoia in PCOS group were significantly higher than those in the control group(P<0.05).The parturients included in this study were further stratified into primipara and multipara.The total score of SCL-90,the number of positive items and the scores of obsession-compulsion,interpersonal sensitivity,psychosis,depression,anxiety,hostility,terror and paranoia in the PCOS group of primipara were significantly higher than those in the control group(P<0.05),but there was no significant difference in multiparae between the two groups(P<0.05).Logistic regression analysis revealed that long married years,high body mass index(BMI)before pregnancy,high education level,female newborn and healthy newborn were independent pr

关 键 词：多囊卵巢综合征 90项症状自评量表(SCL-90) 产后心理 

分 类 号：R714.6[医药卫生—妇产科学]