生活方式与孕期女性焦虑合并抑郁状况的关联  

Associations between lifestyle and comorbid anxiety and depression in pregnant women

作　　者：郑佳琦 黄理瑶 张妍 沈梦碧 王筱金 李红 刘志伟[2] 田英 雷晓宁 高宇 ZHENG Jiaqi;HUANG Liyao;ZHANG Yan;SHEN Mengbi;WANG Xiaojin;LI Hong;LIU Zhiwei;TIAN Ying;LEI Xiaoning;GAO Yu(Department of Environment and Health,School of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;International Peace Maternity and Child Health HospitalClinical Research Center Biostatistics Teaching and Research,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Office,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Mathematics and Applied Mathematics,College of Science,Shanghai University,Shanghai 200444,China;Department of Data Science and Big Data Technology,School of Medical Devices,Shanghai University of Medicine&Health Sciences,Shanghai 200135,China)

机构地区：[1]上海交通大学医学院公共卫生学院环境与健康系,上海200025 [2]上海交通大学医学院附属国际和平妇幼保健院,上海200025 [3]上海交通大学医学院临床研究中心生物统计教研室,上海200025 [4]上海大学理学院数学与应用数学系,上海200444 [5]上海健康医学院医疗器械学院数据科学与大数据技术系,上海200135

出　　处：《环境与职业医学》2024年第3期235-242,共8页Journal of Environmental and Occupational Medicine

基　　金：上海市科委自然科学基金项目(22ZR1435600);上海市2021年度“科技创新行动计划”自然科学基金项目(21ZR1435800);上海护理学会重点项目(2022SD-B02)。

摘　　要：[背景]焦虑和抑郁是孕期女性最常见的心理健康问题。两者通常共病发生,并可能导致严重的不良母婴结局。[目的]评估上海地区女性孕期生活方式与焦虑合并抑郁(CAD)状况的关联。[方法]本研究基于中国国家出生队列(CNBC)辅助生殖技术子代胚胎源性疾病子队列,采用《焦虑自评量表》(SAS)和《抑郁流调量表》(CES–D)分别在孕早、中、晚期评估孕妇的CAD患病率。使用自制问卷、《匹兹堡睡眠质量指数》(PSQI)和《食物摄入频率问卷》(FFQ)收集孕妇的一般人口学资料及各孕期睡眠状况、营养摄入和运动状况等生活方式信息。分别采用二元逻辑回归模型和广义线性混合模型(GLMM)分析孕早、中、晚期生活方式(睡眠状况、营养摄入、运动状况)与孕妇CAD状况(是/否)的横向和纵向关联。[结果]本研究共纳入2876例孕妇,在孕早、中、晚期的CAD患病率分别为10.6%(305例)、3.6%(103例)、5.5%(159例)。逻辑回归分析结果显示,以睡眠状况良好为参照,孕早、中、晚期睡眠状况不佳均与CAD患病率增加存在统计学关联,OR(95%CI)分别为2.817(1.845~4.301)、2.840(1.855~4.347)、9.316(5.835~14.876)。以摄入频率=7次·周^(-1)为参照,孕早期蛋类摄入频率≤3次·周^(-1)(OR=2.025,95%CI:1.197~3.425)及孕晚期摄入频率4~6次·周^(-1)(OR=1.896,95%CI:1.117~3.216)、≤3次·周^(-1)(OR=1.906,95%CI:1.082~3.357)均会增加CAD的患病风险(P<0.05);以运动频率>3次·周^(-1)为参照,孕中期从不或几乎不运动(OR=2.218,95%CI:1.220~4.035)均会增加CAD的患病风险(P<0.05)。GLMM分析结果显示,睡眠状况不佳及较低的运动频率和蔬菜、蛋类、奶类摄入频率均与CAD患病率风险增加存在统计学关联(P<0.05)。[结论]上海地区女性孕早、中、晚期CAD患病率呈U形分布,孕早期最高,孕中期最低。孕期较差的睡眠状况,蔬菜、蛋类、奶类摄入频率和运动频率不足等不良生活方式均可�[Background]Anxiety and depression are common perinatal mental health issues that often occur together and can have serious negative effects on both maternal and infant health.[Objective]To examine the relationships between lifestyle factors and comorbid anxiety and depression(CAD)among pregnant women in Shanghai.[Methods]The study estimated the prevalence of CAD during the first,second,and third trimesters of pregnancy using the Self-rating Anxiety Scale(SAS)and Center for Epidemiological Studies-Depression(CES-D)based on data from the China National Birth Cohort(CNBC)embryonic-derived diseases with assisted reproductive technology(ART)sub-cohort.Information on demographics,sleep status,nutritional intake,and exercise during each trimester was collected through self-made questionnaires,the Pittsburgh Sleep Quality Index(PSQl),and the Food Frequency Questionnaire(FFQ).Lifestyle factors(such as sleep status,nutritional intake,and exercise during each trimester)were analyzed using logistic regression and generalized linear mixed models(GLMM)to determine their impacts on the prevalence of CAD(yes or no)among pregnant women.[Results]A total of 2876 pregnant women were included in this study.The prevalence of CAD was 10.6%(305),3.6%(103),and 5.5%(159)in the first,second,and third trimesters of pregnancy,respectively.The logistic regression analysis revealed that poor sleep quality throughout the entire pregnancy were statistically associated with an increased prevalence of CAD,and the odds ratios(OR)with 95%confidence intervals(Cl)were 2.817(1.845,4.301),2.840(1.855,4.347),and 9.316(5.835,14.876)for the first,second,and third trimesters,respectively,when compared to good sleep quality.Additionally,compared to an intake frequency of 7 times per week,the frequency of egg intake≤3 times per week in the first trimester(OR=2.025,95%Cl:1.197,3.425)and the frequency of egg intake of 4-6 times per week(OR=1.896,95%Cl:1.117,3.216)or≤3 times per week(OR=1.906,95%Cl:1.082,3.357)in the third trimester were ass0-ciated with an

关 键 词：焦虑合并抑郁 心理健康 生活方式 孕妇 孕早期 孕中期 孕晚期 

分 类 号：R17[医药卫生—妇幼卫生保健]