The Research On The Influencing Factors Of Depression And Anxiety In Pregnancy And The Analysis Of Mindfulness-Based Cognitive Therapy

Objective:Analyze the factors that cause depression and anxiety in pregnant women and explore the effect of group mindfulness-based cognitive therapy on anxiety and depression symptoms in pregnant women.Methods:Randomly select 200 pregnant women who have established maternity examination files in local community hospitals and transferred to Subei People’s Hospital of Jiangsu Province from January 2020 to December 2020 to conduct questionnaire surveys.The questionnaire includes self-rating depression scale(SDS),Self-Rating Anxiety Scale(SAS),and self-made questionnaires.The self-made questionnaires including the following four aspects:general informations about pregnant women,previous pregnancy and childbirth history,current pregnancy-related conditions and the understanding of depression and anxiety about pregnancy.Pregnant women with SAS index score<50 and SDS index score<53 are divided into normal group,and those with SAS index score≥50 or SDS index score≥53 are called depression and anxiety group.Then 15 pregnant women who meet the requirements of the intervention were selected as a team by a psychologist for six weeks of psychological intervention based on mindfulness and cognition.At the same time,another 15 pregnant women in the depression and anxiety group with 14-28 weeks of gestation were randomly selected as the control group.These pregnant women need to compare the SAS,SDS,Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)before and after intervention.Use chi-square test and rank sum test for univariate analysis to analyze the factors that may be related to depression and anxiety in pregnancy;use binary logistic regression statistics to analyze the association between meaningful factors and depression and anxiety in pregnancy.The Wilcoxon signed-rank test in the non-parametric test was used to compare the differences of SDS,SAS index scores,HAMA and HAMD scores before and after intervention.Results:Among the 200 pregnant women,22 were anxious pregnant women(11%),of which 20 were mildly anxious(10%),2 were moderately anxious(1%),and 45 were depressed pregnant women(22.5%),including mild depression.39 people(19.5%),6people(3%)with moderate depression,pregnant women without severe anxiety and depression,22 in the first trimester,47 in the second trimester,131 in the third trimester,52 in the positive group and 148 in the negative group.The results of univariate analysis showed the differences of the seven factors whether they were working(χ~2=5.194,P=0.032),education level(Z=-2.227,P=0.006),whether the checkup was abnormal(χ~2=10.449,P=0.030),and the number of abortions(χ~2=9.097,P=0.028),history of bad pregnancy(χ~2=25.168,P=0.000),previous delivery method(χ~2=9.652,P=0.022),and attitude towards patients with depression and anxiety during pregnancy(χ~2=8.131,P=0.043)are statistical significant(P<0.05),and the other factors are not statistically significant(P>0.05).Binary Logistic regression analysis was used to analyze the above seven related factors,taking whether pregnant women suffer from anxiety and depression during pregnancy as the dependent variable,and the above seven factors as independent variables for statistical analysis.The results showed a history of adverse pregnancy(P=0.002,OR=50.184)),whether the checkup result is abnormal(P=0.008,OR=3.127)have an impact on pregnant women suffering from anxiety and depression during pregnancy,which is statistically significant(P<0.05).Eleven pregnant women finally completed the mindfulness-based cognitive therapy,and four pregnant women withdrew from the therapy due to their own reasons,which were not included in the final statistical calculation.The medians of SAS index score,SDS index score,HAMA,and HAMD of the 11 pregnant women before the intervention were 46,57,12,and 12,respectively.After the intervention,they were 43,50,5,and 7.The median of SAS standard scores and the SDS standard scores about the 15 pregnant women in the control group were 47 and56 at the beginning,and 45 and 54 after six weeks of control observation.There was no significant difference in the initial anxiety and depression scores between the intervention group and the control group.After six weeks of intervention,the difference between the two groups of pregnant women’s SAS standard score(Z=-2.369,P=0.018)and SDS standard score((Z=-2.048,P=0.041)was statistically significant.Statistical analysis showed that the differences of SAS index score(Z=-2.552,P=0.011),SDS index score(Z=-2.940,P=0.003),HAMA(Z=-2.806,P=0.005),HAMD(Z=-2.764,P=0.006)are statistically significant.Conclusion:This investigation found that among the various factors of pregnancy,whether they were working during pregnancy,education level,whether the pregnancy check-up was abnormal,the number of miscarriages,the history of bad pregnancy,the previous delivery method,and the attitude to pregnant women with depression and anxiety during pregnancy may be related to the depression and anxiety during pregnancy.History of bad pregnancy and abnormal maternity examination results are risk factors for depression and anxiety during pregnancy.Team-based mindfulness cognitive therapy can improve the mental and physical symptoms of women with anxiety and depression during pregnancy.