复发性流产患者焦虑抑郁的影响因素分析及阶段性变化  

Analysis of influencing factors and stage changes of anxiety and depression in patients with recurrent spontaneous abortion

作　　者：王婷婷[1] 李佳钋 侯悦 乔宠[1] Wang Tingting;Li Jiapo;Hou Yue;Qiao Chong(Department of Obstetrics and Gynecology,Shengjing Hospital of China Medical University,Shenyang Liaoning 110000,P.R.China)

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110000

出　　处：《中国计划生育和妇产科》2024年第1期78-83,共6页Chinese Journal of Family Planning & Gynecotokology

基　　金：辽宁省民生科技计划联合计划项目(项目编号:2021JH2/10300123);沈阳市科技计划项目(项目编号:20-205-4-004);百千万人才工程领军人才(项目编号:XLYC2005008)。

摘　　要：目的探讨复发性流产(recurrent spontaneous abortion,RSA)患者焦虑、抑郁状态的相关影响因素及阶段性变化并提出RSA患者焦虑和抑郁的防控对策。方法选取2019年10月至2021年10月就诊于中国医科大学附属盛京医院的613例未孕育龄期女性为研究对象,根据流产次数将其分为RSA组(495例)、1次流产史组(81例)及对照组(37例),采用电子化问卷针对纳入人群的焦虑、抑郁状态进行前瞻性随访。运用单因素、多因素Logistic回归分析,探索RSA患者焦虑、抑郁的影响因素。结果第一阶段(首次就诊),RSA组患者状态焦虑、特质焦虑及抑郁水平显著高于1次流产史组及对照组。第二阶段(明确病因),RSA患者的状态焦虑、特质焦虑水平显著下降(P<0.05)。多因素Logistic回归显示,距上次流产间隔<6个月和睡眠障碍与状态焦虑、特质焦虑、抑郁共同相关;除此之外,流产次数≥4次与状态焦虑相关;14周后妊娠失败史及低教育程度与特质焦虑相关;低家庭月收入和流产次数≥4次与抑郁相关。结论RSA患者更易出现焦虑、抑郁等负性情绪,可能与教育程度、家庭月收入、距上次流产间隔、流产次数、14周后妊娠失败史及睡眠质量密切相关。且不同诊治阶段,RSA患者焦虑状态不同,明确病因有利于缓解不良情绪。应密切关注RSA患者在不同诊疗阶段产生的心理障碍并提供适当的社会心理支持,缓解过分的焦虑抑郁等负性情绪。Objective To explore the associated factors and stage changes of anxiety and depression in patients with recurrent spontaneous abortion(RSA)and put forward the prevention and control countermeasures of anxiety and depression in RSA patients.Methods A total of 613 non-pregnant women of gestational age in Shengjing Hospital of China Medical University from October 2019 to October 2021 were selected as the study subjects.According to the number of abortions,they were divided into RSA group(495 cases),history of miscarriage once group(81 cases)and control group(37 cases).The anxiety and depression of the enrolled population were prospectively followed up by an electronic questionnaire.Univariate and multivariate Logistic regression analysis were used to explore the associated factors of anxiety and depression in RSA patients.Results At the first stage(the first visit),the level of state anxiety,trait anxiety,and depression in RSA group were significantly higher than those in history of miscarriage once group and control group.In the second stage(identifying the cause),the level of state anxiety and trait anxiety in RSA group decreased significantly(P<0.05).Multivariate Logistic regression showed that duration since last miscarriage<6 months and sleep disturbance were associated with state anxiety,trait anxiety,and depression.In addition,the number of pregnancy loss≥4 was associated with state anxiety;a history of pregnancy loss>14 weeks and low education level were associated with trait anxiety;low monthly household income and the number of pregnancy loss≥4 were associated with depression.Conclusion RSA patients are more likely to develop negative emotions such as anxiety and depression,which may be closely related to education level,monthly household income,duration since last miscarriage,the number of pregnancy loss,history of pregnancy loss>14 weeks and sleep quality.Moreover,the anxiety state of RSA patients varies in different stages of treatment,so identifying the etiology is conducive to alleviating advers

关 键 词：复发性流产 焦虑 抑郁 危险因素 

分 类 号：R714.21[医药卫生—妇产科学]