妇女妊娠晚期和产后不良症状及生活功能的随访调查  

A survey on maternal adverse symptoms and functionality in the third trimester and postpartum

作　　者：刘亚 钱序[1,3] 顾春怡[4] 梁爽[4] 沈蓓蓓[4] 孙丽萍[4] LIU Ya;QIAN Xu;GU Chunyi;LIANG Shuang;SHEN Beibei;SUN Liping(School of Public Health,Fudan University,Shanghai 200032,China;Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Key Laboratory of Health Technology Assessment of the Ministry of Health,Fudan University,Shanghai 200032,China;Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]上海市疾病预防控制中心,上海200336 [3]国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海200032 [4]复旦大学附属妇产科医院,上海200011

出　　处：《上海预防医学》2024年第8期771-778,共8页Shanghai Journal of Preventive Medicine

基　　金：上海市公共卫生体系建设三年(2020—2022);行动计划重点学科项目(GWV-10.1-XK08)。

摘　　要：【目的】利用中文版孕产疾患测量工具(WOICE问卷)测量上海妇女孕产疾患发生情况,了解妊娠晚期和产后不良症状及生活功能现状并分析其相关因素。【方法】招募2021年3—8月到上海市某三级妇产专科医院初诊建卡的妊娠妇女并完成基线调查,在妊娠晚期和产后6周分别调查其孕产疾患发生情况。【结果】妊娠晚期、产后6周分别有89.8%、86.1%的妇女自报不良生理症状;焦虑、抑郁患病率在妊娠晚期为4.1%、6.2%,产后6周为6.2%、7.5%;妊娠晚期、产后6周自报有生活功能损伤的比例分别为80.3%、64.1%。生理症状受经产情况、学历、孩子健康状况及受暴力风险影响;心理症状受年龄、家务承担情况、有无工作、孩子健康状况、孕前体重指数(BMI)及受暴力风险影响;生活功能受户籍、学历、家务承担情况、受暴力风险影响。【结论】上海孕产妇的生理健康状况好于国外中等收入地区,焦虑与抑郁处于国内一般水平。生理、心理、生活功能水平受个人、健康、家庭、工作多种因素影响。可从多个角度预防不良症状及生活功能损伤,改善孕产良性体验。[Objective]To use the maternal morbidity WOICE Too(l Chinese version)to investigate the maternal morbidity in Shanghai,and to examine the current situation and associated factors of adverse symptoms and impaired functioning in the third trimester and postpartum period.[Methods]Pregnant women who made their initial visit and established a medical record at a tertiary obstetrics and gynecology hospital in Shanghai from March to August 2021 were recruited and a baseline survey was completed.The prevalence of maternal morbidity was surveyed in the third trimester and first 6 weeks postpartum.[Results]Self-reported adverse physical symptoms were observed in 89.8%of women in the third trimester and 86.1%in first 6 weeks postpartum.The prevalence rates of anxiety and depression were 4.1%and 6.2%in the third trimester,and 6.2%and 7.5%in first 6 weeks postpartum,respectively.The proportions of women reporting impaired functioning were 80.3%in the third trimester and 64.1%in first 6 weeks postpartum,respectively.Physical symptoms were associated with parity,education,the newborn’s health status,and risk of experiencing violence.Psychological symptoms were associated with age,household responsibilities,employment status,the newborn’s health status,pre-pregnancy body mass index(BMI),and risk of experiencing violence.Functionality was associated with the type of registered residence,education level,household responsibilities,and risk of experiencing violence.[Conclusion]The physical health status of pregnant and postpartum women in Shanghai is better than that in the middle-income regions abroad,with anxiety and depression at average levels compared to national statistics in China.Physical,psychological,and functional status are affected by multiple factors including personal,health,family,and work conditions.Preventive measures should be taken from various perspectives to mitigate adverse symptoms and impaired functioning,and to improve the positive experience of pregnancy and childbirth.

关 键 词：孕产妇 WOICE测量工具 生理症状 焦虑 抑郁 生活功能 

分 类 号：R173[医药卫生—妇幼卫生保健]