A Study On The Relationship Between Anxiety,Stress And Its Relationship With Preterm Delivery

ObjectiveObjective to investigate the anxiety and stress status of pregnant women in Guangxi,and analyze the influencing factors.Follow up study,to understand the incidence of preterm delivery and to explore the relationship between preterm delivery and stress 、 anxiety during pregnancy.The purpose is to provide theoretical basis for carrying out the health care for pregnant women in Guangxi in the futureMethodsIn this study,Nanning maternal and child health care hospital and Qinzhou Maternal and Child Health-Care Hospital were investigated.A total of 1547 pregnant women who were selected as subjects,and they were diagnosed and conceived during the maternity period in March and October 2016 in the two maternal and child health care clinics.They volunteered to participate in the study.A self-designed questionnaire was used to investigate the basic demographic,biological data,past pregnancy history and other related data of pregnant women;At the same time,the anxiety self-rating scale and pregnancy pressure scale were used to evaluate the anxiety and stress status of pregnant women during pregnancy.The pregnancy outcome of the pregnant women was investigated and the related factors were analyzed.Epidata3.1 software was usedto establish the database,and the valid questionnaires were double and double entry.Finally,the SPSS16.0 software was used to analyze the data.Quantitative data were statistically analyzed by X + s,t test or variance analysis was used to compare between groups,and multiple factors analysis was adopted multiple linear regression analysis.Qualitative data were statistically analyzed by frequency and component ratio.Chi square test was used to compare the differences between groups.According to the results of the single factor analysis,P<0.20 was included in the logistic multi factor regression model.According to the 0.05 entry level,0.1 of the discharge level was gradually logistic regression.ResultsⅠ.The basic situation of the respondents: the average age of the 1547 subjects was(28.07+4.76)years.There are 982 Han people(63.5%),521 Zhuang people(33.7%),and 44 other ethnic minorities(2.8%).The average gestational age during the study was(19.07 + 6.32)weeks,and 554 for the first time,accounting for 35.8% of the total number.There are 587 cases of tertiary or undergraduate education,accounting for 37.9% of the total number.1042cases(67.4%)of pregnant women had normal BMI before pregnancy.Ⅱ.The incidence and influencing factors of the survey: 1547 cases of anxiety survey anxiety score was(37.95 + 7.65)points,of which 120 cases in a state of anxiety(7.76%),including 109 cases of mild anxiety(90.84%),10 cases of moderate anxiety(8.33%),1 cases(accounting for severe anxiety 0.83%).Among the 120 investigated subjects,59 were Zhuang(49.16%),54 Han(45%),and 7 other ethnic minorities(5.84%).80 cases were in middle pregnancy,21 cases were in early pregnancy,19 cases were in late pregnancy.After the single factor analysis showed that age,nationality,education level,gestational age,pregnancy included menstruation during pregnancy,whether the law is wearingradiation-proof clothes such as pregnancy anxiety score differences between groups was statistically significant(t or F=7.817,20.551,2.406,5.119,10.578,5.969;P < 0.05).Whether the pregnant woman was in a state of anxiety during pregnancy was a dependent variable(Y=1: the pregnant woman was in a state of anxiety,and Y=0: the pregnant woman was not in a state of anxiety).In the age of pregnant women,pregnant women,ethnic education,into the gestational age,menstruation is regular,pregnancy is wearing radiation-proof clothes as the independent variable,Logistic regression was conducted showed that pregnant women of ethnic,age is influence factors of anxiety.Compared with Han Zhuang,Zhuang and Han is the risk of the occurrence of anxiety 2.172 times(OR=2.172,P<0.001);compared to other minorities and Han nationality and other ethnic minorities anxiety and the risk is 3.240 times the Han(OR=3.240,P=0.007).The older the more pregnant women not prone to anxiety(OR=0.544,P=0.035).Spearman rank correlation method was used to analyze the correlation between the total anxiety score and the total score of stress.III.The stress status of the subjects and its influencing factors: the total score of the pregnancy stress of the 1547 subjects was(1.41 + 0.31)points,at moderate pressure levels.Levels of stress: 0 cases without pressure(0%),mild pressure in 0 cases(0%),moderate pressure in 1467 cases(94.8%),severe pressure in 80 cases(5.2%).Of the 30 entries for the pregnancy stress scale,2 of the positive items were in the top ten,and six were stressors.By univariate analysis,age,nationality,pregnancy pregnant women is menstrual regularity,whether there is a previous pregnancy,often cooking,during pregnancy,whether the use of lipstick and other pregnancy stress the actual score differences between groups was statistically significant at home(t or F=12.165,5.117,6.965,14.706,12.074,7.721;P < 0.05).After multiple linear regression analysis,thealpha =0.05 level variables X1(age),X2(premenstrual regularity),X3(who have pregnancy),X4(whether at home,often cooking),X5(during pregnancy,whether the use of lipstick)and strain Y(pregnancy pressure).Linear regression was statistically significant.IV.Follow up observation of pregnancy outcome and observation of preterm birth: 98 cases of preterm delivery in 1547 cases,the incidence of preterm birth was 6.3%(domestic 7.2%).Among the premature pregnant women,68 were Han(69.4%),28 were Zhuang(28.6%),and 2 were other ethnic minorities(2%).There were 29 cases of first pregnant women,accounting for 29.6% of the total number of premature births.There are 40 cases of tertiary or undergraduate education,accounting for 40.8% of the total number.56 cases(57.1%)of the pregnant women with normal BMI;5 cases in a state of anxiety,4 cases of mild anxiety,1 patients with moderate anxiety,0 cases of severe anxiety;pregnant women are high pressure,which is in the moderate pressure state in 93 cases,in 5 cases of severe stress.V.Spearman rank correlation method was used to analyze the correlation between the total anxiety score and the total stress score of 1547 subjects.The results showed that the total score of anxiety was positively related to the total score of stress(r=0.322,P<0.001).The relationship between anxiety,stress and preterm birth: 98 cases of preterm labor in pregnant women,5 cases in a state of anxiety,4 cases of mild anxiety,1 patients with moderate anxiety,0 cases of severe anxiety;pregnant women are high pressure,in which 93 cases of moderate pressure,5 cases of severe stress state.Chi square test results showed that pregnant women in different pregnancy stress and anxiety level of the difference between the incidence of premature birth was not statistically significant,statistically significant incidence of pregnancy and menstrualregularity of two groups of pregnant women,premature difference(P < 0.05).Logistic regression analysis showed that the regularity of pregnancy menstruation and whether or not to wear radiation protection during pregnancy were the factors influencing premature delivery.Compared with the pregnant women with irregular menstruation,the risk of premature delivery in pregnant women with irregular menstruation is 0.516 times higher than that of pregnant women with irregular menstruation before pregnancy(OR=0.516,P=0.008).Compared with pregnant women who did not wear radiation suits,pregnant women who wore radiation protective clothing were 0.414 times more likely to develop preterm clothes than those who did not wear radiation suits..ConclusionOnly 7.76% of pregnant women in Guangxi in a state of anxiety,anxiety and age of different ethnic groups appear to have influence;Guangxi pregnant women showed a moderate and above the pressure level,the main pressure from the maternal and child health safety concerns,age,history of pregnancy,pregnancy,menstruation is often do housework during pregnancy,the use of lipstick or not affects the pressure the status of pregnant women.The study did not find that anxiety levels and stress levels were directly related to preterm birth,and that preterm birth was related to the regularity of menstruation before pregnancy and whether or not to wear radiation suits during pregnancy...