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妊娠糖尿病患者孕中晚期社会支持与抑郁、焦虑及妊娠结局的相关性分析

Relationships of social support with depression, anxiety and pregnancy outcome in patients with gestational diabetes mellitus in the second and third trimesters

    摘要
  • 摘要:
    目的 探讨妊娠糖尿病(GDM)患者孕中晚期社会支持水平与抑郁、焦虑及妊娠结局的关系。
    方法 采用纵向研究设计方法, 通过社会支持评定量表(SSRS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)等工具对2020年7月—2022年3月于扬州市妇幼保健院定期产检的孕中晚期GDM患者进行调查，并随访统计其妊娠结局。
    结果 211例GDM患者孕中晚期社会支持总分为(38.39±6.17)分，处于中等水平; 102例患者发生不良妊娠结局。线性回归分析显示，孕妇的工作情况显著影响社会支持总分(P < 0.05), 家庭居住地、孕期家庭经济支持情况影响客观支持评分(P < 0.05), 产次影响主观支持评分(P < 0.05), 工作情况、丈夫学历、孕期家庭经济支持影响对支持的利用度评分(P < 0.05)。相关性分析结果显示，客观支持、对支持的利用度、总社会支持与产后出血呈负相关(r=-0.194、-0.240、-0.203, P < 0.05); SDS评分与分娩出巨大儿呈正相关(r=0.258, P < 0.05)。二元Logistic回归分析显示，对支持的利用度是产后出血的保护因素(OR=0.440, 95%CI: 0.264~0.734, P=0.002), 抑郁(OR=2.118, 95%CI: 1.088~4.125, P=0.027)、孕前体质量指数(OR=1.223, 95%CI: 1.096~1.364, P < 0.001)是GDM患者分娩巨大儿的危险因素，丈夫学历是GDM患者分娩巨大儿的保护因素(OR=0.268, 95%CI: 0.120~0.595, P=0.001)。
    结论 GDM患者孕中晚期社会支持水平与抑郁、焦虑情绪密切相关，提升孕中晚期社会支持水平是改善GDM患者妊娠结局的潜在干预策略。

     

    Abstract:
    Objective To explore the relationships of social support with depression, anxiety and pregnancy outcome in patients with gestational diabetes mellitus (GDM) in the second and third trimester of pregnancy.
    Methods A longitudinal study was conducted to investigate the patients diagnosed with GDM in Yangzhou Maternal and Child Health Hospital from July 2020 to March 2022 by using Social Support Rating Scale (SSRS), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and other tools, and to follow up the pregnancy outcomes.
    Results The social support scores of 211 GDM patients were (38.39±6.17), which were in the middle level. There were 102 cases of adverse pregnancy outcomes. Linear regression analysis showed that the working situation of pregnant women significantly affected the total score of social support (P < 0.05), family residence and family economic support during pregnancy affected the objective support score (P < 0.05), and the parity affected the subjective support score (P < 0.05). Workingstatus, husband's education background and family economic support during pregnancy affected the utilization of support (P < 0.05). The results of correlation analysis showed that objective support, utilization of support and total social support were negatively correlated with postpartum hemorrhage (r=-0.194, -0.240, -0.203, P < 0.05). Binary Logistic regression analysis showed that the utilization of support was a protective factor for postpartum hemorrhage (OR=0.440; 95%CI, 0.264 to 0.734; P=0.002), and depression (OR=2.118; 95%CI, 1.088 to 4.125; P=0.027) and pre-pregnancy body mass index (OR=1.223; 95%CI, 1.096 to 1.364; P < 0.001) were risk factors for macrosomia in GDM patients, and husband's education background was a protective factor for macrosomia in GDM patients (OR=0.268; 95%CI, 0.120 to 0.595, P=0.001).
    Conclusion The level of social support is closely related to depression and anxiety. Therefore, improving the level of social support in the second and third trimesters of pregnancy is a potential intervention strategy to improve the pregnancy outcome of GDM patients.

     

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