不同孕期中社会支持各维度与孕期抑郁状态的关联研究

A study on the relationship between different dimensions of social support during pregnancy and depressive state during pregnancy

摘要:

目的 探索深圳地区孕妇社会支持各维度与孕期抑郁状态的关联。方法 采用结构式问卷调查的方式，在2018年8月~2020年6月期间对某三甲妇幼保健院进行孕期检查的孕妇进行问卷调查，共收集到信息完整问卷1396份。采用卡2检验、Wilcoxon秩和检验分析基线相关特征，采用多因素logistics回归模型估计社会支持与孕期抑郁状态的比值比（OR）及95%置信区间，并进行亚组分析。结果 抑郁状态组和非抑郁状态组在教育水平、医疗保险率、户籍、家庭月收入、经产妇比例、丈夫为独生子女比例、孕期压力和社会支持间的差异具有统计学意义。多因素调整后，社会支持总分的OR（95%CI）为0.97（95%CI 0.95-0.99），客观支持维度的OR（95%CI）为0.90（95%CI 0.87-0.94），且与孕期的相乘交互项具有显著的统计学意义（P>0.05）。对孕期进行分层分析发现，社会支持总分仅在孕晚期与孕期抑郁状态显著相关，OR（95%CI）为0.97（95%CI 0.94-0.99）。客观支持维度在孕早期、孕晚期与孕期抑郁状态显著相关，OR（95%CI）分别为0.78（95%CI 0.61-0.99）和0.89（95%CI 0.84-0.94），支持利用度维度在孕晚期的OR值为0.91（95%CI 0.83-0.99）。结论 社会支持与孕期抑郁状态呈显著的负相关，且在孕晚期尤为重要。社会支持各维度在各个孕期中与孕期抑郁状态的相关程度不同，客观支持维度在孕早期及孕晚期尤为重要。

Abstract:

Objective To explore the relationship between social support and pregnancy depression in Shenzhen. Methods During August 2018 and June 2020, a structure questionnaire survey was conducted among pregnant women who underwent pregnancy examination in a third-grade maternal and child health care hospital. A total of 1396 questionnaires with complete information were collected. Chi-square test and Wilcoxon rank sum test were used to analyze the baseline characteristics. The odds ratio (OR) and 95%CI confidence interval between social support and pregnancy depression were estimated using logistics regression model. subgroup analysis was also conducted. Results There were statistically significant differences in education level, medical insurance rate, household registration, family monthly income, proportion of pluripara, husband being the only child, pregnancy stress and social support between depression group and non-depression group. After multi-factors adjustment, the OR (95%CI) of the total social support score was 0.97(95%CI 0.95-0.99), the OR (95%CI) of the objective support dimension was 0.90(95%CI 0.87-0.94), and the P value of the interaction term multiplied by pregnancy term was less than 0.05. According to the stratified analysis of pregnancy, the total score of social support was significantly correlated with the depressive status only in the third trimester, OR (95%CI) was 0.97(95%CI 0.94-0.99). Objective support dimension was significantly correlated with depression status in the first and third trimesters, the OR (95%CI) was 0.78(95%CI 0.61-0.99) and 0.89(95%CI 0.84-0.94), respectively. The OR of support utilization score in the third trimesters was 0.91(95%CI 0.83-0.99). Conclusion Social support is negatively correlated with depression during pregnancy and is particularly important in the third trimester. Dimensions of social support were differently correlate with depressive status during pregnancy. Objective support dimension is particularly important in first and last trimester, and the utilization of social support is significantly negatively correlated with depressive state during pregnancy in last trimester.