Risk Factors For Adverse Psychological Status During Pregnancy And Correlation With Maternal And Child Prognosis

Objective:Pregnancy is a special physiological period for women of childbearing age,and women in pregnancy may experience both psychological and physical challenges during the long period of pregnancy.The purpose of the study was to determine the prevalence of depressive symptoms,anxiety symptoms,and stress symptoms in the third trimester of pregnancy,to explore the risk factors of adverse psychological states during pregnancy for women,and to analyze their prognostic impact on the mother and child,and to provide a theoretical basis for the development of psychological-related health care during pregnancy.Methods:Randomly selected pregnant women from September 2020 to September 2022 in the obstetrics outpatient delivery and hospitalization at Shengjing Hospital Affiliated to China Medical University,were surveyed using a cell phone self-answering questionnaire.The psychological status of women in the third trimester of pregnancy was assessed using Self-Rating Depressive Scale(SDS),Self-Rating Anxiety Scale(SAS),and Pregnancy Stress Rating Scale(PSRS).Pregnancy-related information and pregnancy outcomes were counted after their deliveries were completed.The data were statistically analyzed using SPSS 26.0 software for descriptive analysis,χ2 test and one-way and multi-way logistic regression analysis.Results:The prevalence of depressive symptoms among 581 pregnant women was 24.3%,the prevalence of anxiety symptoms was 22.9%,and the prevalence of moderate and above stress symptoms was 34.4%.After including variables with statistically significant χ~2 tests in the multifactorial logistic regression analysis.The results showed that concern for fetal sex and post-embryo transfer were risk factors for depressive symptoms in pregnancy,disharmony between mother-in-law and daughter-in-law and severe pregnancy vomiting were risk factors for anxiety symptoms in pregnancy,and concern about fetal sex and low monthly income are risk factors for stress symptoms in women in pregnancy.In this study,the incidence of preterm delivery was 5.7%.The results of one-way logistic regression analysis showed statistically significant associations between depressive symptoms of pregnancy and preterm delivery,gestational diabetes mellitus,hypertensive disorders of pregnancy,and severe vomiting(P<0.05),between anxiety symptoms of pregnancy and preterm delivery,gestational diabetes mellitus,hypertensive disorders of pregnancy,premature rupture of membranes,and severe vomiting(P<0.05),and between stress symptoms of pregnancy and hypertensive disorders of pregnancy and severe vomiting(P<0.05).Results of multifactorial logistic regression analysis controlling for confounding factors showed that depressive symptoms of pregnancy were the main risk factor for severe vomiting,anxiety symptoms of pregnancy were the main risk factor for preterm delivery,premature rupture of membranes,gestational diabetes,hypertensive disorders of pregnancy and severe vomiting,and stress symptoms of pregnancy were the main risk factor for hypertensive disorders of pregnancy.Conclusion:Adverse mental state during pregnancy is an important factor affecting the outcome of pregnancy such as premature delivery.In order to improve maternal and infant outcomes,we should actively conduct mental health screening during pregnancy,timely discover related risks and provide corresponding psychological support.