地震对孕妇心理状态及妊娠结局的影响
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摘要
目的了解地震灾害对孕妇产前情绪状态及其对妊娠结局的影响,为灾后心理干预及孕期保健提供科学依据。方法用焦虑自评量表(SAS)、抑郁自评量表(SDS)对2008-06/11间在四川省人民医院妇产科就诊的成都市区95名及重灾区市县68名孕妇进行产前问卷调查,调查时间为灾后1月及灾后3月,产后各组分析其分娩孕周及方式、产后出血、新生儿体重及APGAR评分等情况。结果灾后1月及灾后3月,重灾区市县孕妇组焦虑及抑郁指数明显高于成都市区,灾后3月与灾后1月相比,重灾区市县孕妇组焦虑情况有改善;与成都市区孕妇妊娠结局相比,重灾区市县分娩孕周较早,急诊剖宫产率较高,新生儿出生体重偏轻。结论地震灾害给孕妇身心健康造成严重损害,而灾后心理危机干预是非常重要的,灾后心理危机干预工作越早进行越有效,灾后产科医疗人员应加强孕期保健,对相关产后风险做出正确的评估和预防。
Objective To investigate the adverse effects of earthquake on psychological state and pregnancy outcome of pregnant women and provide scientific basis for mental intervention and health measures of pregnant women after earthquake.Methods Ninety five pregnant women from Chengdu area and 68 pregnant women from disaster areas were respectively tested with prenatal SAS and SDS questionnaires between June and November 2008.After birth,the indexes including gestational weeks and model,postpartum hemorrhage,body weight of neonate,APGAR score were analysed.Results The self-rating scales of anxiety and depression among pregnant women from disaster areas were significantly higher than that of pregnant women from Chengdu area from one to three monthes,while anxiety of pregnant women from disaster areas was improved after three monthes.Compared with pregnant outcome of pregnant women from Chengdu area,gestational weeks were earlier,uterine-incision delivery were higher,birth weights of neonates were lighter in pregnant women from the disaster areas.Conclusion Earthquake caused serious harm for physical and mental health of pregnant women.Therefore,mental intervention after earthquake is very important,and more early more effective.The medical staff of obstetrics should strengthen antenatal care after disaster,correctly evaluate and prevent the postpartum risk.
Objective To investigate the adverse effects of earthquake on psychological state and pregnancy outcome of pregnant women and provide scientific basis for mental intervention and health measures of pregnant women after earthquake.Methods Ninety five pregnant women from Chengdu area and 68 pregnant women from disaster areas were respectively tested with prenatal SAS and SDS questionnaires between June and November 2008.After birth,the indexes including gestational weeks and model,postpartum hemorrhage,body weight of neonate,APGAR score were analysed.Results The self-rating scales of anxiety and depression among pregnant women from disaster areas were significantly higher than that of pregnant women from Chengdu area from one to three monthes,while anxiety of pregnant women from disaster areas was improved after three monthes.Compared with pregnant outcome of pregnant women from Chengdu area,gestational weeks were earlier,uterine-incision delivery were higher,birth weights of neonates were lighter in pregnant women from the disaster areas.Conclusion Earthquake caused serious harm for physical and mental health of pregnant women.Therefore,mental intervention after earthquake is very important,and more early more effective.The medical staff of obstetrics should strengthen antenatal care after disaster,correctly evaluate and prevent the postpartum risk.
引文
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[2]Tang HS,Kuo CJ,Chen CT,et al.Acute psychiatric disor-ders in the bereaved survivors of a disaster earthquake[J].Taiwanese J Psychiatry,2000,14:218-227.
[3]张明圆.精神科评定量表手册[M].长沙:湖南科技出版社,1993:35-42.
[4]陆秀风,沈国梅,孙岳琴,等.产后抑郁症的原因分析及预防对策[J].重庆医学,2006,36(15):1402-1403.
[5]Kitamura T,Shima S,SugawaraM,et al.Psychological andsocial correlates of the onset of affective disorders among preg-nant women[J].Psychol Med,1993,23:967-975
[6]韩蓁,李芬,崔丽侠,等.孕期抑郁症的调查分析[J].中国心理卫生杂志,1996,10(增刊):63-65.
[7]Laura M Glynn,Pathik D Wadhwa,Christin,et al.Whenstress happens matters:Effects of earthquake timing on stressresponsibility in pregnancy[J].Am J Obstet Gynecol.2001,184:637-642.
[8]Hseuh-ling Chang,Ting-chang Chang,Tzou-yien Lin,et al.Psychiatric morbidity and pregnancy outcome in a disaster ar-ea of Taiwan 921 earthquake[J].Psychiatry and ClinicalNeurosciences,2002,56:139-144.
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