孕早期焦虑、抑郁与孕中期增重关系的前瞻性研究  

Correlation between anxiety,depression in early pregnancy,and weight gain in second trimester:a prospective study

作　　者：普诗涵 陈聪 陈思佳 杨梦彤 王芃鹏 曾果 PU Shi-han;CHEN Cong;CHEN Si-jia;YANG Meng-tong;WANG Peng-peng;ZENG Guo(Department of Nutrition and Food Hygiene,West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院营养与食品卫生学系,四川成都610041

出　　处：《现代预防医学》2023年第7期1245-1250,共6页Modern Preventive Medicine

基　　金：达能营养中心膳食营养研究与宣教基金(DIC2016-06)。

摘　　要：目的 调查了解成都地区孕早期妇女焦虑、抑郁现状,探讨孕早期焦虑、抑郁对孕中期增重的影响。方法 利用成都孕妇队列开展前瞻性研究,整群随机选取2017年成都市某三甲妇幼保健机构产前门诊孕6~14周单胎健康孕妇作为研究对象。通过问卷调查收集孕妇基本信息。采用《焦虑自评量表》( self-rating anxiety scale, SAS) 和《抑郁自评量表》( self-rating depression scale, SDS)收集孕早期妇女焦虑和抑郁信息,分别计算孕早期焦虑和抑郁标准得分,按三分位数分别由低到高分为三水平组(T1、T2、T3),参照中国常模标准分别评价孕早期焦虑和抑郁状态。分别于孕6~14周、24~28周测量孕妇体重,计算孕中期增重速率,依据《中国妊娠期妇女体重增长推荐值标准》(WST801-2022)判断孕中期增重状态(过缓、适宜和过快)。采用多因素非条件logistic回归分析探讨孕早期焦虑和抑郁分别与孕中期增重之间的关系。结果 最终有效样本量为986例。孕早期平均焦虑、抑郁标准得分分别为(37.94±7.00)、(40.43±8.95)分,焦虑、抑郁发生率分别为6.5%、9.1%。平均孕中期增重速率为(0.40±0.18) kg/周,增重适宜率为53.4%,增重过缓率为17.7%,增重过快率为28.8%。控制混杂因素后,多因素非条件logistic回归分析结果显示,与孕早期抑郁标准得分低水平组(T1)比较,高水平组(T3)孕妇发生孕中期增重过快的风险明显增加 (OR=1.46,95%CI:1.02~2.08);未观察到孕早期抑郁与孕中期增重过缓有关,未观察到孕早期焦虑与孕中期增重异常有关。结论 成都地区孕妇孕中期增重异常问题严峻,孕早期焦虑和抑郁问题不容忽视,孕早期抑郁可能增加孕中期增重过快的风险,孕早期焦虑抑郁与孕期增重关系有待进一步研究。Objective To investigate the current status of anxiety and depression among women in early pregnancy in Chengdu,and to explore the effects of anxiety and depression in early pregnancy on weight gain in the second trimester.Methods A prospective study was conducted based on the Chengdu pregnant women cohort,and a whole group of healthy single pregnant women with 6-14 weeks of pregnancy were randomly selected as the research objects in the prenatal clinic of a third-grade maternal and child health institution in Chengdu in 2017.The basic information of pregnant women was collected through questionnaires.Self-rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were used to collect anxiety and depression information.The scores of anxiety and depression were calculated,and they were divided into three groups(T1,T2,and T3)according to the tertiles from low to high.The state of anxiety and depression was evaluated according to the Chinese norm standard.The weight of pregnant women was measured at 6 to 14 weeks and 24 to 28 weeks of gestation,and the rate of weight gain in the second trimester was calculated.The status of weight gain(over-slow,appropriate,and over-fast)was determined according to the Chinese Recommended Value of weight gain for pregnant Women(WST801-2022).Multivariate unconditional logistic regression was used to analyze the relationship between anxiety and depression in the first trimester and weight gain in the second trimester.Results The final valid sample size was 986 cases.The mean of anxiety and depression score in the first trimester were(37.94±7.00)points and(40.43±8.95)points,and the incidences of anxiety and depression were 6.5%and 9.1%,respectively.The mean of weight gain rate in the second trimester was(0.40±0.18)kg/week,the appropriate rate of weight gain was 53.4%,the over-slow rate of weight gain was 17.7%,and the over-fast rate of weight gain was 28.8%.After controlling for the confounding factors,multivariate unconditional logistic regression analysis showed that compared w

关 键 词：焦虑 抑郁 孕中期增重 

分 类 号：R715.3[医药卫生—妇产科学] R714.7[医药卫生—临床医学]