摘要
目的探索不同工作状态对全孕期抑郁情绪的影响。方法前瞻性纳入2020年12月至2021年4月于首都医科大学附属北京天坛医院建档的396名孕早期女性,年龄20~45岁,排除抑郁障碍、双相情感障碍等精神障碍患者。基线采用爱丁堡产后抑郁量表(EPDS)、疲劳严重度量表、心理弹性量表评估其精神心理状态和工作状态,并在孕中期、孕晚期再次随访。依据工作状态将其分为全职组(252名)、兼职组(97名)和无业组(47名)。采用3(组别)×3(孕期)重复测量方差分析比较孕期抑郁情绪的差异,并采用多元线性回归分析工作状态对孕期抑郁情绪的影响。结果无业组的孕期女性较其他组受教育程度更低、疲劳得分更高[本科及以下学历占比:85.2%(40/47)比64.3%(162/252);疲劳得分:(37.5±9.3)分比(33.1±11.2)分](均P<0.05)。工作组别和孕期因素对抑郁得分的主效应差异均有统计学意义(F=3.19,P=0.043;F=6.20,P=0.002),孕早期抑郁量表得分[EPDS经过lg(x+1)转换所得]显著高于孕晚期[(0.6±0.01)比(0.5±0.01),P=0.003],各工作组别之间抑郁量表得分差异无统计学意义(PBonferroni校正>0.017);交互效应差异无统计学意义(F=1.34,P=0.253)。多因素回归分析结果显示全职或兼职工作、婚姻满意度越高、心理弹性越好,孕中期抑郁得分越低(R2调整后=0.34,F=22.37,P<0.001)。结论孕期全职和兼职工作均对孕中期抑郁情绪具有保护作用,而对孕早期和孕晚期的抑郁情绪未发现显著关联。
Objective To evaluate the mood and psychological state of pregnant women with different working states and analyze the influence of working on depression state during the entire pregnancy.Methods A total of 396 women aged 20-45 years were prospectively enrolled in Capital Medical University Affiliated Beijing Tian Tan Hospital in early pregnancy from December 2020 to April 2020.The ones who had a history of depressive disorder,bipolar disorder,and other mental disorders were excluded.Their psychological states were assessed by the Edinburgh Postnatal Depression Scale(EPDS),the Fatigue Severity Scale(FSS),and the Connor-Davidson Resilience Scale(CD-RISC)at baseline,the second and third trimester of pregnancy accordingly.Based on employment status during pregnancy,they were analyzed into Full-time(252 cases),Part-time(97 cases),and Unemployed(47 cases)groups.A 3(Group)×3(Pregnancy trimester)repeated measures ANOVA was used to compare the differences in EPDS scores among the three groups.Multivariate Linear Regression was used to analyze the effects of employment status and other factors on EPDS scores during pregnancy.Results Compared to the Full-time and Part-time employment groups,the Unemployed group had lower education levels and higher FSS scores[ones who own a bachelor′s degree or below:85.2%(40/47)vs 64.3%(162/252);FSS score:(37.5±9.3)vs(33.1±11.2)](all P<0.05).Repeated measures ANOVA showed the main effect of group and time on EPDS depression scores was statistically significant(F=3.19,P=0.043;F=6.20,P=0.002).EPDS scores in early pregnancy were significantly higher than those in late pregnancy[(0.6±0.01)vs(0.5±0.01),P=0.003].There was no significant difference in EPDS scores among different groups(PBonferroni correction>0.017).There were no statistically significant interaction effects between the three groups and three trimesters of pregnancy(F=1.34,P=0.253).Regression analysis results showed that Full-time or Part-time employment,higher marital satisfaction,better psychological resilience contributed fewer depression scores in the second trimester of pregnancy(R2adjusted=0.34,F=22.37,P<0.001).Conclusion Both Full-time and Part-time employment during pregnancy have a positive impact on depressive mood in the second trimester of pregnancy but probably no impact in the early and late pregnancy.
作者
李月真
张佳丽
姚懿馨
范文娟
张璇
张轶
陈瑛
张宁
王春雪
Li Yuezhen;Zhang Jiali;Yao Yixin;Fan Wenjuan;Zhang Xuan;Zhang Yi;Chen Ying;Zhang Ning;Wang Chunxue(Department of Neuropsychiatry,Behavioral Neurology and Clinical Psychology,Sleep Center,Beijing Tian Tan Hospital,Capital Medical University,Beijing 100070,China;Department of Health Management Center,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451464,China;Department of Obstetrics and Gynecology,Beijing Tian Tan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2024年第2期94-99,共6页
Chinese Journal of Psychiatry
基金
首都卫生发展科研专项项目(2020-2-2044)
北京市卫生健康科技成果和适宜技术推广项目(BHTPP2022030)。
关键词
抑郁症
孕期抑郁情绪
无业
孕期工作
影响因素
Depressive disorder
Pregnancy depression state
Unemployed
Pregnancy work
Influence factor
