可疑抑郁高危孕妇的睡眠质量对妊娠压力的影响

The impact of sleep quality on pregnancy stress in pregnant women at high-risk of suspected depression

摘要

目的 了解北京市海淀区孕妇心理健康状态,筛查可疑抑郁高危者的睡眠质量及妊娠压力情况,探讨睡眠质量对妊娠压力的影响,为孕妇健康睡眠和良好情绪管理,以及指导保健工作提供参考依据。方法 选取2020年7月至2021年12月期间在北京市海淀区妇幼保健院进行心理健康筛查的可疑抑郁高危孕妇[病人健康问卷抑郁量表(简称PHQ-9抑郁量表)总分≥5分],并完成心理复评的1869人为研究对象.采用妊娠压力量表(PSRS)和匹斯堡睡眠质量指数量表(PSQI)对孕妇进行问卷调查,比较不同睡眠维度间妊娠压力的差异,采用多因素Logistic回归模型评价孕期睡眠质量对增加妊娠压力的风险。结果 在1869名孕妇中,出现妊娠压力有574名,占30.7%;妊娠压力源得分由高到低排序前4位分别为“害怕疼痛厉害”(占60.9%)、“担心婴儿不正常”(占60.0%)、“担心婴儿能否安全分娩”(占59.8%)和“担心分娩是否安全”(占55.6%).孕妇睡眠质量得分较高(即睡眠质量较差)的前3个维度分别为“日间功能障碍”,平均为(1.52±0.95)分;“睡眠效率”,平均为(1.26±1.38)分;“入睡时间”,平均为(0.91±0.86)分;其中睡眠质量差占比最高(40.1%).经多因素Logistic回归分析显示,PSQI总分高(β=1.426)及主观睡眠质量差(β=0.987)、入睡时间长(β=0.938)、睡眠时间不足(β=1.017)、有睡眠干扰因素(β=2.253)、有日间功能障碍(β=0.926)5个维度均对孕妇妊娠压力有影响(P<0.05);年龄(OR=0.951,95%CI:0.922~0.982)、孕周(OR=1.025,95%CI:1.012~1.038)及PSQI总分(OR=4.127,95%CI:3.314~5.140)的增高均会导致孕妇妊娠压力的增加(P<0.05)。结论 可疑抑郁高危孕妇妊娠期睡眠质量差增加了妊娠压力的风险.

Abstract

Objective To understand the mental health status of pregnant women in Haidian District, Beijing, and to screen the sleep quality and pregnancy stress of high-risk suspected depression individuals, explore the impact of sleep quality on pregnancy stress, and provide reference for healthy sleep and emotional management of pregnant women, as well as guidance for healthcare work. Methods A total of 1869 pregnant women who underwent psychological health screening for suspected depression in Beijing Haidian District Maternal and Child Health Hospital from July 2020 to December 2021 [patients with a total score of ≥5 on the Patient Health Questionnaire-9 depression scale (PHQ-9 depression scale for short)] and completed psychological reevaluation were selected as the research subjects. Questionnaires, including the pregnancy stress rating scale (PSRS) and the Pittsburgh sleep quality index (PSQI), were administered to assess pregnant women's stress levels across different dimensions of sleep. A multivariable logistic regression model was used to evaluate the risk of increased pregnancy stress associated with sleep quality during pregnancy. Results Among 1869 pregnant women, 574 experienced pregnancy stress, accounting for 30.7% of the total. The top four sources of pregnancy stress, ranked from high to low, were “fear of severe pain” (60.9%), “concerns about the baby's health” (60.0%), “worries about the safety of childbirth for the baby” (59.8%), and “concerns about the safety of childbirth” (55.6%). The first three dimensions with higher scores of pregnant women's sleep quality (indicating poorer sleep quality) were “daytime dysfunction” with an average score of (1.52±0.95), “sleep efficiency” with an average score of (1.26±1.38), and “time to fall asleep” with an average score of (0.91±0.86), among which poor sleep quality had the highest proportion (40.1%). Multivariable logistic regression analysis revealed that a higher PSQI total score (β=1.426) and subjective poor sleep quality (β=0.987), long time to fall asleep (β=0.938), insufficient sleep duration (β=1.017), presence of sleep disturbances (β=2.253), and daytime dysfunction (β=0.926) significantly influenced pregnancy stress in pregnant women (P<0.05). Increasing age (OR=0.951, 95%CI: 0.922-0.982), gestational age (OR=1.025, 95%CI: 1.012-1.038), and PSQI total score (OR=4.127, 95%CI: 3.314-5.140) were associated with increased pregnancy stress in pregnant women (P<0.05). Conclusion Pregnant women at high risk of suspected depression with poor sleep quality during pregnancy are at increased risk of pregnancy stress.

关键词

孕期 / 心理健康筛查 / 妊娠压力 / 睡眠质量

Key words

pregnancy / mental health screening / pregnancy stress / sleep quality

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基金资助

国家自然科学基金资助项目(32271136)