摘要
目的探讨早孕反应和睡眠质量与孕早期女性轻中度抑郁的关联性。方法纳入2023年9月~2024年6月在南通大学附属妇幼保健院心理咨询门诊就诊的孕早期女性,根据PHQ-9量表结果评估抑郁症状的严重程度。t检验和χ^(2)检验进行差异性分析,多变量logistic回归模型估计与早孕反应和睡眠质量与抑郁水平之间关联性,限制性立方样条拟合睡眠质量与抑郁水平的曲线关系。结果283名对象包括轻度抑郁204人,中度抑郁79人。两组间文化程度、早孕反应、婚姻情况、妊娠次数、分娩次数、睡眠质量和PSQI评分差异有统计学意义(P<0.05)。多模型结果显示,与无早孕反应相比,轻微早孕反应(OR=2.62,95%CI 1.36~5.06;2.75,95%CI 1.41~5.39;2.84,95%CI1.41~5.72)和严重早孕反应(OR=4.01,95%CI 1.88~8.54;3.42,95%CI 1.56~7.48;3.44,95%CI1.52~7.82)在所有模型中都与中度抑郁的风险呈正相关;与睡眠质量很好的相比,其他所有睡眠状态在所有模型中都与中度抑郁的风险呈显著正相关(P<0.05)。曲线拟合结果表明,PSQI评分与中度抑郁水平呈线性的正向关联(Poverall<0.001,Pnonlinearity=0.420),9分以上时中度抑郁的风险随睡眠质量的变坏而增加。结论在孕早期,早孕反应和睡眠质量与中度抑郁的风险显著相关;PSQI评分超过9分时,中度抑郁的风险显著增加。妇幼保健机构应对孕早期人群的早孕反应和睡眠质量进行早期评估,有针对性地制定干预措施,从而减少中度抑郁的发生。
Objective To explore the correlation between early pregnancy reactions,sleep quality,and mild to moderate depression in early pregnant women.Methods Early pregnant women who visited the psychological counsel-ing clinic at the Affiliated Maternal and Child Health Hospital of Nantong University from September 2023 to June 2024 were included.The severity of depressive symptoms was assessed based on the results of the PHQ-9 scale.T-tests and chi-square tests were used for difference analysis,and a multivariate logistic regression model was employed to estimate the association between early pregnancy reactions,sleep quality,and the level of depression.Restricted cubic splines were used to fit the curvilinear relationship between sleep quality and the level of depression.Results A total of 283 subjects were included,consisting of 204 with mild depression and 79 with moderate depression.There were statisti-cally significant differences in educational level,early pregnancy reactions,marital status,number of pregnancies,number of deliveries,sleep quality,and PSQI scores between the two groups(P<0.05).Multi-model results showed that compared with no early pregnancy reactions,mild early pregnancy reactions(OR=2.62,95%CI 1.36~5.06;2.75,95%CI 1.41~5.39;2.84,95%CI 1.41~5.72)and severe early pregnancy reactions(OR=4.01,95%CI 1.88~8.54;3.42,95%CI 1.56~7.48;3.44,95%CI 1.52~7.82)were positively associated with the risk of moderate depression in all models;compared with very good sleep quality,all other sleep states was significantly positively associated with the risk of moderate depression in all models(P<0.05).The curve fitting results indicated that the PSQI score was linearly and positively associated with the level of moderate depression(Poverall<0.001,Pnonlinearity=0.420),and the risk of moderate depression increased as sleep quality worsened when the score was above 9.Conclusion In early pregnancy,morning sickness and sleep quality are significantly associated with the risk of moderate depression.When the PSQI score exceeds 9,the risk of moderate depression significantly increases.Maternal and child health institutions should conduct early screening for morning sickness and sleep quality in early pregnancy populations,and develop targeted in-tervention measures,and reduce the occurrence of moderate depression.
作者
莫朝霞
吴郁琼
王巧真
平鹏
顾玲琪
MO Zhaoxia;WU Yuqiong;WANG Qiaozhen(Nantong Maternal and Child Health Hospital,Nantong 226018,China)
出处
《国际精神病学杂志》
2025年第3期874-877,889,共5页
Journal Of International Psychiatry
基金
南通市科技计划项目(编号:MSZ2023119)
江苏卫生创新种子基金(编号:CX2023006)。
关键词
早孕反应
睡眠质量
抑郁
关联性分析
Early pregnancy reactions
Sleep quality
Depression
Correlation analysis
