胚胎移植女性孕早期睡眠质量及关联因素分析  

Sleep quality and associated factors during early pregnancy after embryo transfer

作　　者：万芳芳[1] 高源 张杰[1] 李爱民[1] 范艳丽 管延彧 刘玲[2] WAN Fangfang;GAO Yuan;ZHANG Jie;LI Aimin;FAN Yanli;GUAN Yanyu;LIU Ling(Hebei Key Laboratory of Infertility and Genetics,Hebei Clinical Research Center for Birth Defects,Hebei Medical Key Discipline of Reproductive Medicine,Hebei Collaborative Innovation Center of Integrated Traditional and Western Medicine on Reproductive Disease,Department of Reproductive Medicine,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China;Department of Gynaecology and Obstetrics,the Third Medical Center,Chinese PLA General Hospital,Beijing 100039,China;Beijing University of Aeronautics and Astronautics,Beijing 100083,China)

机构地区：[1]河北医科大学第二医院生殖医学科,河北省出生缺陷临床医学研究中心,河北省不孕不育与遗传重点实验室,河北石家庄050000 [2]解放军总医院第三医学中心妇产科,北京100039 [3]北京航空航天大学,北京100083

出　　处：《解放军医学院学报》2024年第7期724-730,745,共8页Academic Journal of Chinese PLA Medical School

基　　金：河北省省级科技计划(21377720D)。

摘　　要：背景胚胎移植女性经受了身体和心理的双重挑战,孕早期的生活质量,尤其是睡眠质量会受到较大的影响。目的分析胚胎移植女性孕早期睡眠质量及相关影响因素。方法选取2022年6—12月于河北医科大学第二医院生殖医学科进行体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)助孕成功的患者,在其移植后45 d返院复查B超时进行问卷调查,调查内容包括匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、中文简化版心理弹性量表(Connor Davidson resilience scale,CD-RISC)和社会支持评定量表。以PSQI>7分为判断睡眠障碍的标准,通过多因素Logistic回归模型分析睡眠质量与各个影响因素的关系,并使用信息增益算法对影响睡眠质量的主要因素进行影响程度评估。结果发放问卷336份,回收325份,回收率96.7%。325例IVF-ET孕妇年龄(32.46±4.52)岁,睡眠质量总分为(7.79±3.63)分,其中126例孕妇总分≤7分为睡眠正常组,199例孕妇总分>7分为睡眠障碍组(61.23%,199/325)。相关心理学评估:焦虑自评量表(43.75±8.86)分;抑郁自评量表(50.89±10.54)分;心理弹性量表总分(64.18±11.34),其中坚韧性(32.66±10.28)分,力量性(21.75±6.37)分,乐观性(9.74±3.26)分;社会支持评定量表总分为(42.27±4.93)分,其中客观支持(9.15±2.13)分,主观支持(25.30±4.26)分,对支持的利用度(7.82±1.91)分。Logistic回归结果提示,年龄越大、越焦虑,越容易出现睡眠障碍;文化程度中,以初中及以下人群作为参照,高中或中专学历的人群更不容易出现睡眠障碍;心理弹性水平越高,睡眠障碍出现概率越低(P均<0.05)。信息增益分析结果显示,影响睡眠质量的因素按影响力大小依次为心理弹性中的坚韧性(1.186)、社会支持量表中的主观支持分(0.807)、心理弹性量表中的力量性(0.806)、�Background Women undergoing embryo transfer have experienced both physical and psychological challenges,and their quality of life in the first trimester of pregnancy,especially their sleep quality,has been greatly affected.Objective To analyze the sleep quality and related factors of embryo transfer(ET)female in early pregnancy.Methods Patients with successful IVF-ET assisted pregnancy in the Reproductive Medicine Department of the Second Hospital of Hebei Medical University from June to December in 2022 were selected,and a questionnaire survey was conducted when they returned to the hospital 45 days after transplantation for re-examination B-ultrasound.The investigation included Pittsburgh Sleep Quality Index(PSQI),Self Rating Anxiety Scale(SAS),Self Rating Depression Scale(SDS),Simplified Chinese version of the Psychological Resilience Scale(CDRISC),and Social Support Rating Scale were applied.PSQI>7 was used as the criterion to diagnose sleep disorders.The relationship between sleep quality and various influencing factors was analyzed by multivariate Logistic regression model,and the influence degree of major factors affecting sleep quality was evaluated by using information gain algorithm.Results Totally 336 questionnaires were sent out and 325 were collected,with a recovery rate of 96.7%.The age of 325 IVF-ET pregnant women was(32.46±4.52)years.The participants achieved a score of(43.75±8.86)on the SAS,(50.89±10.54)on the SDS.The total score of mental resilience scale on the psychological resilience scale was(64.18±11.34),with subscore of(32.66±10.28)for tenacity,(21.75±6.37)for strength,and(9.74±3.26)for optimism.The total score on the social support rating scale was(42.27±4.93),which included an objective support subscore of(9.15±2.13),a subjective support subscore of(25.30±4.26),and a subscore for utilization of support of(7.82±1.91).Logistic regression results suggested that older age and higher levels of anxiety were associated with a greater likelihood of experiencing sleep disorders.Compare

关 键 词：体外受精-胚胎移植 孕妇 睡眠质量 心理弹性 社会支持 焦虑 抑郁 信息增益 调查研究 

分 类 号：R71[医药卫生—妇产科学]