吴玮 王宁宁 孙曼

[摘要] 目的 探討全孕期心理管理对孕期出现异常情绪且具有不良孕产史的孕妇妊娠结局的影响，寻求有效的方法改善异常情绪，从而改善妊娠结局。 方法 选取2018年1月至2020年6月期间全孕期在我院定期产检、具有不良孕产史的孕妇，按照抑郁自评量表（Self-rating Depression Scale，SDS）和焦虑自评量表（Self-rating Anxiety Scale，SAS）进行筛查，将有轻、中度抑郁和（或）焦虑的患者作为研究对象，共100例，随机分成两组，试验组在常规产检的基础之上，于早、中、晚孕期进行心理管理，对照组进行常规产检，比较两组剖宫产率、产后2 h阴道出血量、早产率及孕早期、孕晚期抑郁、焦虑评分。 结果 试验组孕早期SAS、SDS评分与对照组比较，差异无统计学意义（P>0.05）。经过全孕期心理管理后，试验组孕晚期SAS、SDS评分明显低于其孕早期评分（P<0.05）;对照组孕妇孕晚期SAS、SDS评分与其孕早期评分比较无明显改变，差异无统计学意义（P>0.05）;孕晚期试验组SAS、SDS评分明显低于对照组SAS、SDS评分（P<0.05）。试验组剖宫产率（30.00%）低于对照组（60.00%）（χ2=9.090，P<0.05）;试验组早产率与对照组比较，差异无统计学意义（χ2=0.560，P>0.05）;试验组产后2 h出血量（166.70±52.50）mL明显低于对照组（262.80±82.70）mL，差异有统计学意义（P<0.05）。 结论 全孕期心理管理可以有效改善具有异常情绪的不良孕产史孕妇的妊娠结局。

[关键词] 不良孕产史孕妇;异常情绪;全孕期心理管理;妊娠结局

[中图分类号] R473.71          [文献标识码] A          [文章编号] 1673-9701（2021）08-0016-04

The influence of psychological management during the whole pregnancy on pregnancy outcome of pregnant women with abnormal mood and bad pregnancy history

WU Wei   WANG Ningning   SUN Man

Department of Obstetrics， Maternal and Child Health Care Hospital of Jiujiang City in Jiangxi Province， Jiujiang  332000， China

[Abstract] Objective To explore the influence of psychological management during the whole pregnancy on pregnancy outcome of pregnant women with abnormal emotions and bad pregnancy history， and to seek effective methods to improve abnormal emotions， thereby improving pregnancy outcome. Methods Pregnant women undergoing regular checkups with bad pregnancy history in our hospital from January 2018 to June 2020 were selected and screened according to the Self-rating Depression Scale（SDS） and Self-rating Anxiety Scale（SAS）. One hundred patients with mild to moderate depression and/or anxiety were selected as the research object. They were randomly divided into two groups. The experimental group received psychological management based on the routine obstetric examination. The control group underwent routine obstetrics. The cesarean section rate， vaginal bleeding in 2 hours postpartum， premature delivery rate， and depression and anxiety scores in the early and late pregnancy between the two groups were compared. Results There was no statistical difference in the SAS and SDS scores between the experimental group and the control group in the early pregnancy（P>0.05）. After psychological management during the whole pregnancy， the SAS and SDS scores of the experimental group in the late pregnancy were significantly lower than those of the early pregnancy（P<0.05）.The control group had no significant changes in the SAS and SDS scores in the late pregnancy compared with the early pregnancy， and the difference was not statistically significant（P>0.05）. The SAS and SDS scores of the experimental group in the late pregnancy were significantly lower than those of the control group（P<0.05）. The cesarean section rate in the experimental group（30.00%） was lower than that（60.00%） in the control group（χ2=9.090， P<0.05）. There was no statistical difference in the preterm delivery rate between the experimental group and the control group（χ2=0.560， P>0.05）. The 2 hours postpartum bleeding in the experimental group（166.70±52.50） mL was significantly lower than that of the control group（262.80±82.70）mL， and the difference was statistically significant（P<0.05）. Conclusion Psychological management during the whole pregnancy can effectively improve the pregnancy outcome of pregnant women with abnormal mood and bad pregnancy history.

[Key words] Pregnant women with bad pregnancy history; Abnormal emotions; Psychological management throughout pregnancy; Pregnancy outcome

随着妇幼工作方针的推行及现代医学模式的转变，妇女心理保健受到了越来越高的重视。孕妇不仅要经历孕期生理功能过度负荷状态，还要承受生理变化、社会角色、家庭角色转变所带来的心理压力。妊娠期妇女常出现的异常情绪为抑郁和焦虑。全球围产期情绪异常的发病率为10%～20%，其中北美及欧洲的围产期抑郁患病率为9%～15%，产后焦虑的患病率为8%～10%[1-2]，且焦虑和抑郁的患病率均表现为发展中国家高于发达国家[3]。我国……