五色风险分级下孕妇产前抑郁的发生情况及其对妊娠结局的影响

Prevalence of prenatal depression among pregnant women under the five-color risk classification and its impact on pregnancy outcomes

摘要

目的 研究分析妊娠晚期五色风险分级下孕妇产前抑郁的发生情况,进一步探讨不同颜色分级中孕妇抑郁症状发生差异对妊娠结局的影响。方法 选取2022年10月1日至2023年10月1日在川北医学院附属医院产检的740例妊娠晚期孕妇作为研究对象.对孕妇进行五色风险分级,采用爱丁堡产后抑郁量表(Edinburgh postnatal depression scale,EPDS),选取9.5分作为阈值将各级人群分为抑郁组与非抑郁组,比较各级人群中抑郁组和非抑郁组的妊娠结局情况。结果 根据五色风险管理,将研究对象分为绿色组86例、黄色组326例、橙色组307例、红色组12例、紫色组9例;妊娠晚期检出存在抑郁症状者248人(33.5%),其中橙色风险抑郁症状者人数占比最大(45.2%),红色风险分级中产前抑郁发生率最高(41.7%),橙色风险分级中次之(36.5%),但差异无统计学意义(P>0.05);不同风险分级下孕妇EPDS量表平均得分差异有统计学意义,两两比较显示红色组、橙色组得分较高(F=2.653,P<0.05);在黄色风险分级中,抑郁组孕妇的新生儿出生体重较低,差异有统计学意义(t=1.997,P<0.05);在橙色风险分级中,抑郁组孕妇早产发生率、社会因素剖宫产占比高于非抑郁组,差异有统计学意义(χ²值分别为4.673、4.707,P<0.05);绿色及红色风险中两组孕妇之间妊娠结局无统计学差异(P>0.05)。结论 妊娠晚期孕妇的抑郁症状普遍存在,红色和橙色风险孕妇发生产前抑郁症状较为显著.黄色风险中产前抑郁对新生儿出生体重造成影响,橙色风险中产前抑郁对早产、社会因素剖宫产率造成影响,其余颜色风险中结局指标均无显著差异.妊娠晚期不同五色风险分级孕妇的抑郁状况存在差异,并对妊娠结局产生影响.

Abstract

Objective To investigate the prevalence of prenatal depression among pregnant women in the third trimester under the five-color risk classification system, and to further explore how differences in depressive symptoms across the different risk levels affect pregnancy outcomes. Methods A total of 740 pregnant women in their third trimester who underwent prenatal checkups at the Affiliated Hospital of North Sichuan Medical College between October 1, 2022, and October 1, 2023, were enrolled in the study. Each participant was categorized using the five-color risk classification system. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for depression, with a cutoff score of 9.5 to classify participants within each risk level into either a depression group or a non-depression group. Pregnancy outcomes were compared between the two groups at each risk level. Results According to the five-color risk management system, participants were divided into the following groups: green (86 cases), yellow (326 cases), orange (307 cases), red (12 cases), and purple (9 cases). Prenatal depressive symptoms were detected in 248 women (33.5%) in the third trimester. The orange group had the highest proportion of women with depressive symptoms (45.2%), while the red group had the highest rate of prenatal depression (41.7%), followed by the orange group (36.5%). However, the differences were not statistically significant (P>0.05). The mean EPDS scores varied significantly across risk levels, with pairwise comparisons showing higher scores in the red and orange groups (F=2.653, P<0.05). In the yellow group, newborns born to women with depression had significantly lower birth weights (t=1.997, P<0.05). In the orange group, the rates of preterm birth and cesarean delivery due to social factors were significantly higher in the depression group compared to the non-depression group (χ²=4.673 and 4.707, respectively, P<0.05). No significant differences in pregnancy outcomes were found between the depression and non-depression groups in the green and red groups (P>0.05). Conclusions Depressive symptoms are common among women in the third trimester of pregnancy. Those classified under red and orange risk levels are more likely to experience prenatal depression. In the yellow group, prenatal depression is associated with lower neonatal birth weight, while in the orange group, it is linked to higher rates of preterm birth and cesarean delivery due to social factors. No significant differences in pregnancy outcomes were observed in the other risk levels. These findings suggest that depressive symptoms vary across different five-color risk classifications and can affect pregnancy outcomes.

关键词

孕产妇 / 产前抑郁 / 五色风险管理 / 妊娠结局

Key words

pregnant and postpartum woman / prenatal depression / five-color risk management / pregnancy outcome

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基金资助

国家工业和信息化部、国家卫生健康委员会«5G+医疗健康应用试点项目»批准立项项目(JKZX2022G5G03)