体质量指数、孕期增重及其他相关因素对产后抑郁的影响  

Effects of Body Mass Index,Gestational Weight Gain and Other Related Factors on Postpartum Depression

作　　者：沈武娟 沈雪琴 王志坚 SHEN Wujuan;SHEN Xueqin;WANG Zhijian(Department of Obstetrics and Gynecology,the Affiliated Jiangsu Shengze Hospital of Nanjing Medical University,Suzhou 215228,Jiangsu,China)

机构地区：[1]南京医科大学附属江苏盛泽医院妇产科,江苏苏州215228

出　　处：《医学信息》2025年第8期87-91,共5页Journal of Medical Information

基　　金：苏州市医疗卫生基础研究项目(编号:SYSD2019048)。

摘　　要：目的 分析孕前体质量指数(BMI)、产时BMI、孕期增重(GWG)及其他相关因素对产后抑郁(PPD)的影响。方法 选择2019年11月-2020年11月在江苏盛泽医院分娩的558例单胎分娩产妇作为研究对象。根据孕前BMI分为孕前低体重组(BMI<18.5 kg/m^(2))、正常体重组(BMI 18.5~24.9 kg/m^(2))和超重/肥胖组(BMI≥25.0 kg/m^(2))。另根据产时BMI分为产时正常体重组(BMI 18.5~24.9 kg/m^(2))、超重组(BMI 25~29.9 kg/m^(2))、肥胖组(BMI≥30 kg/m^(2))。参照美国医学研究会(IOM)发布的GWG推荐值,将研究对象分为GWG不足组、GWG适宜组和GWG过多组。分析孕前BMI、产时BMI、GWG及其他相关因素与产后爱丁堡产后抑郁量表(EPDS)评分的相关性。结果 孕前超重/肥胖组孕妇产后EPDS评分高于低体重组及正常体重组孕妇(P<0.05)。GWG过多组产后EPDS评分高于GWG不足组和GWG适宜组(P<0.05)。产时肥胖组产后EPDS评分高于产时正常体重组和产时超重组(P<0.05)。多元线性回归分析显示,非意愿妊娠、父母照顾、孕前超重/肥胖、GWG过多、混合喂养与产后EPDS评分呈正相关性;而产次、喂养效果良好、夫妻关系良好与产后EPDS评分呈负相关性(P<0.05)。结论 孕前超重/肥胖和GWG过多女性更易发生PPD,孕前对超重/肥胖的干预及孕期的合理体重管理,可预防PPD的发生。在围产期保健时应同时重视非意愿妊娠、夫妻关系紧张和初产的孕妇,了解其心理健康状况。Objective To analyze the effects of pre-pregnancy body mass index(BMI),intrapartum BMI,gestational weight gain(GWG) and other related factors on postpartum depression(PPD).Methods A total of 558 singleton parturients who gave birth in the Affiliated Jiangsu Shengze Hospital of Nanjing Medical University from November 2019 to November 2020 were selected as the study subjects.According to pre-pregnancy BMI,they were divided into pre-pregnancy low weight group(BMI<18.5 kg/m^(2)),normal weight group(BMI 18.5-24.9 kg/m^(2)) and overweight/obese group(BMI≥25.0 kg/m^(2)).According to the intrapartum BMI,they were divided into normal weight group(BMI 18.5-24.9 kg/m^(2)),overweight group(BMI 25-29.9 kg/m^(2)) and obese group(BMI≥30 kg/m^(2)).According to the recommended value of GWG issued by the American Institute of Medicine(IOM),the subjects were divided into GWG insufficient group,GWG appropriate group and GWG excessive group.The correlation between pre-pregnancy BMI,intrapartum BMI,GWG and other related factors and postpartum Edinburgh Postpartum Depression Scale(EPDS) score was analyzed.Results The postpartum EPDS score of pregnant women in the pre-pregnancy overweight/obesity group was higher than that of pregnant women in the low weight group and normal weight group(P<0.05).The postpartum EPDS score in the excessive GWG group was higher than that in the insufficient GWG group and the appropriate GWG group(P<0.05).The postpartum EPDS score of intrapartum obesity group was higher than that of intrapartum normal weight group and intrapartum overweight group(P <0.05).Multivariate linear regression analysis showed that unwanted pregnancy,parental care,pre-pregnancy overweight/obesity,excessive GWG,mixed feeding were positively correlated with postpartum EPDS score.The parity,good feeding effect and good relationship between husband and wife were negatively correlated with postpartum EPDS score( P<0.05).Conclusion Women with prepregnancy overweight/obesity or excessive GWG are more susceptible to PPD.Interventions t

关 键 词：体质量指数 妊娠 孕期增重 产后抑郁 爱丁堡产后抑郁量表 

分 类 号：R715.3[医药卫生—妇产科学] R749.4[医药卫生—临床医学]