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目的研究上海闸北、普陀、虹口地区192例妊娠晚期孕妇的精神心理健康状况及其对分娩方式影响。方法选取于2013年11月-2015年11月期间上海闸北,普陀,虹口地区妊娠晚期192例孕妇为研究对象,使用SCL-90量表以及一般情况调查表对其心理健康状况进行调查,通过电话了解或查阅分娩资料等方法了解其分娩方式并分为剖宫产组与自然分娩组,比较其SCL-90量表总分以及各因子的得分,并分析影响其精神心理健康状况的因素。结果所有妊娠晚期孕妇的SCL-90量表平均得分为(145.70±28.90)分,显著高于国内常模的(129.90±38.80)分,差异具有统计学意义(P<0.05),其中心理症状检出率较高的前五位分别为躯体化症状、强迫症状、抑郁、焦虑以及人际关系敏感,其中躯体化症状检出率达到了30.2%。剖宫产组孕妇的SCL-90量表平均得分为(148.30±27.20)分,显著高于自然分娩组的(131.50±31.30)分,且在躯体化症状、强迫症状、焦虑、抑郁、精神病性、人际关系敏感上高于自然分娩组,差异具有统计学意义(P<0.05)。影响妊娠晚期孕妇精神心理健康状况的原因主要有大学(专)及其以上学历、与公婆关系差、有家族遗传病史、有孕期用药史以及流产次数≥2次。结论妊娠晚期的孕妇由于多种因素的作用易出现各种心理问题,包括躯体症状、强迫、焦虑、抑郁等,容易对分娩方式造成影响,临床上应引起重视并做好心理疏导工作。
Objective To investigate the mental and psychiatric status of 192 pregnant women in the third trimester of pregnancy in Zhabei, Putuo and Hongkou areas of Shanghai and their effects on the mode of delivery. Methods A total of 192 pregnant women in the third trimester of pregnancy in Zhabei, Putuo and Hongkou districts of Shanghai from November 2013 to November 2015 were selected as the study subjects. The SCL-90 scale and the general situation questionnaire were used to investigate their mental health status. By telephone Understand or consult the delivery information and other methods to understand the mode of delivery and divided into caesarean section group and natural delivery group, compare the SCL-90 scale total score and the score of each factor, and analyze the factors that affect their mental and mental health status. Results The average score of SCL-90 in all pregnant women of the third trimester was (145.70 ± 28.90) points, which was significantly higher than that of the norm in China (129.90 ± 38.80), the difference was statistically significant (P <0.05) The top five patients with higher rates were somatization, obsessive-compulsive disorder, depression, anxiety and interpersonal sensitivity respectively. The detection rate of somatization was 30.2%. The average SCL-90 score of pregnant women in the cesarean section group was (148.30 ± 27.20) points, which was significantly higher than that in the spontaneous delivery group (131.50 ± 31.30), and was significantly higher in somatization, obsessive-compulsive disorder, anxiety, depression and psychosis , The interpersonal sensitivity was higher than that of spontaneous delivery group, the difference was statistically significant (P <0.05). The main reasons that affect the mental and mental health status of pregnant women in the third trimester are university (special) and above education, poor relationship with in-laws, family history of inheritance, history of medication during pregnancy and the number of miscarriage ≥2 times. Conclusions Pregnant women in the third trimester tend to have various psychological problems due to many factors, including somatic symptoms, compulsions, anxiety and depression, which may easily affect the mode of delivery. Therefore, they should pay more attention to psychological counseling in clinic.