孕期心理健康状态与睡眠质量的纵向研究  

Longitudinal study of gestational psychological health and sleep quality

作　　者：季文佳 饶琳[3] 周璇 刘志伟[3] 李红 JI Wenjia;RAO Lin;ZHOU Xuan;LIU Zhiwei;LI Hong(Nursing Department,Rujin Hospital Afiliated to Jiaotong University School of Medicine,Shanghai 200025,China;不详)

机构地区：[1]上海交通大学医学院附属瑞金医院护理部,上海200025 [2]上海交通大学护理学院,上海200025 [3]上海交通大学医学院附属国际和平妇幼保健院护理部,上海200030

出　　处：《中华全科医学》2023年第9期1552-1555,1589,共5页Chinese Journal of General Practice

基　　金：科技部国家重点研发计划项目(2022YFC2702903,2016YFC1000203);上海交通大学医学院护理学科建设项目(沪交医[2021]21);上海市护理学会重点项目(2022SD-B02)。

摘　　要：目的 探讨孕期女性心理健康状态、睡眠质量变化,分析孕期睡眠质量影响因素。方法 选择2020年1月—2021年12月于上海交通大学医学院附属国际和平妇幼保健院产检的3 904例自然受孕女性为研究对象,使用焦虑自评量表(SAS)、抑郁自评量表(CES-D)、压力感知量表(PSS-10)、匹兹堡睡眠质量指数(PSQI)评估孕早期(10~14孕周)、孕中期(20~24孕周)、孕晚期(28~32孕周)女性的心理健康状态和睡眠质量,分析睡眠质量影响因素。结果 孕早期女性的焦虑、抑郁、有压力占比分别为11.83%、42.32%、71.47%,较孕中、晚期高;孕早、中、晚期睡眠质量问题占比分别为14.81%、50.59%、16.14%;线性混合模型分析显示,焦虑(B=0.548,P<0.001)、抑郁(B=0.768,P<0.001)、压力(B=0.649,P=0.002)、年龄(B=0.646,P=0.023)、大专及以上学历(B=0.699,P=0.023)、无业(B=0.429,P=0.004)、家庭收入(B=0.452,P=0.039)、孕次(B=0.608,P=0.044)、产次(B=0.606,P=0.017)是孕期女性睡眠质量问题的影响因素(均P<0.05),随机截距模型显示随着孕期时间增加,孕期不同女性睡眠质量变化趋势相同(B=9.621,P<0.001)。结论 孕期女性易出现焦虑、抑郁、压力等心理问题,且孕期心理健康与睡眠质量息息相关,妇幼专科技术人员应及时关注孕早期心理状况及孕期睡眠质量。Objective To explore changes of gestational psychological health and sleep quality in women,and to analyze influencing factors of sleep quality.Methods A total of 3904 natural conception women undergoing antenatal examinations in the International Peace Maternity&Child Health Hospital,Shanghai Jiao Tong University School of Medicine were enrolled as the research objects from January 2020 to December 2021.The psychological health and sleep quality of women in early(10-14 gestational weeks),middle(20-24 gestational weeks)and late pregnancy(28-32 gestational weeks)were evaluated by self-rating anxiety scale(SAS),the center for epidemiological studies depression scale(CES-D),the perceived stress scale(PSS-10)and Pittsburgh sleep quality index(PSQI),and influencing factors of sleep quality were analyzed.Results In early pregnancy,proportions of anxiety,depression and stress were 11.83%,42.32%and 71.47%,which were higher than those in middle and late pregnancy.The proportions of sleep disorders in early,middle and late pregnancy were 14.81%,50.59%and 16.14%,respectively.Linear mixed model analysis showed that anxiety(B=0.548,P<0.001),depression(B=0.768,P<0.001),stress(B=0.649,P=0.002),age(B=0.646,P=0.023),education level of college degree or above(B=0.699,P=0.023),unemployment(B=0.429,P=0.004),family income(B=0.452,P=0.039),gravidity(B=0.608,P=0.044)and parity(B=0.606,P=0.017)were influencing factors of sleep disorders(all P<0.05).The random intercept model showed that with the increase of pregnant time,the change trend of sleep quality was the same in women with different gestational periods(B=9.621,P<0.001).Conclusion The incidence of psychological problems(anxiety,depression,stress)is high in women during pregnancy.Gestational psychological health is closely related to sleep quality.Professional staffs for women and children should pay attentions to psychological status in early pregnancy and sleep quality during pregnancy.

关 键 词：孕期女性 孕期 焦虑 压力 抑郁 睡眠质量 相关性 

分 类 号：R725.3[医药卫生—儿科]