Role Of Anxiety And Depression In The Pathogenesis Of Spontaneous Preterm

BackgroundPremature birth (preterm birth) is the full28weeks gestation less than37weeks between (196-258days) deliveries. In China,5%to15%of the total number of premature births, about15percent of the deaths occur in preterm children in the neonatal period. Therefore, to prevent preterm birth is to reduce perinatal child mortality, one of the important measures to improve the quality of the newborn Spontaneous preterm birth is a major cause of premature birth, ie at least28weeks gestation less than37weeks, followed by deliveries of labor occurs spontaneously Currently, our research on risk factors for preterm birth focused on maternal age, body mass index, prenatal care, abortion, bad habits such as smoking, and the more risk factors are a large number of clinical studies have shown a close with spontaneous preterm related. Some researchers believe that the impact of spontaneous preterm birth by psychosomatic disorders. Particularly on anxiety, depression, psychosomatic diseases aggravated development plays an important role has been studied confirmed. The mechanism may involve physiological and pathological roles of the limbic system. However, the current research on psychological factors associated with preterm birth is still very small, anxiety, depression are risk factors for spontaneous preterm birth is still not very clear.ObjectiveThrough this study cohort study of203pregnancies list, and to explore the role of anxiety and depression in the pathogenesis of spontaneous preterm birth, to provide help for pregnant women in clinical psychology intervention.Subjects and MethodsLinfen City of Shanxi between2011-2013, a list of203pregnancies in this study. The use of self-administered questionnaire method, with Spielberg’s status-Trait Anxiety Inventory (Spielberger’s State-Trait Anxiety Inventory), see Schedule I, and Edinburgh Depression Scale (the Edinburgh depression scale), see Table II conduct investigations in the role of anxiety and depression in the onset of spontaneous preterm birth. Using SPSS17.0statistical software for data analysis.ResultsFirst, this study analyzes the social and biomedical characteristics of the population of pregnant women participating in the survey. Sociodemographic and biomedical characteristics of the study enrolled203pregnant women, as shown in Table1. Among them, the average age of respondents was28.5years (standard deviation [(Standard Deviation, SD),5.5, range18-45years]. Vast majority of women are married, and Han Chinese. Women with higher levels of education accounted for about a quarter of all respondents, while62%of respondents in regular employment, slightly more than10percent of those surveyed continue to smoke during pregnancy, and12%of the study population are heavy smokers (10or more/day or more). approximately10%of respondents had a history of preterm birth, about5percent had a history of spontaneous preterm birth.Second, the psychological state of the present study participated in the survey analysis. In all those involved in this study203pregnant women,21pregnant women, accounting for11.2%, to obtain a high depression score (score≥15) at the Edinburgh Postnatal Depression Scale. Survey average score was7.2. Spielberg in20states-Trait Anxiety Inventory score analysis, we identified the critical score of45(75th percentile), and that the score of the survey with state anxiety and trait anxiety scores range from a minimum of to a maximum of20to80, an average value of36.4(SD,12.1). Trait anxiety scores range from20-73, with an average of38.8.Third, the study participated in the survey spontaneous preterm birth risk factors and psychological factors. In the survey, the incidence of spontaneous preterm birth in 11.4%(22/203). The survey appears in preterm gestational age, with an average of32weeks±5weeks. In univariate analysis of the survey on spontaneous preterm birth, and spontaneous preterm delivery was significantly associated with covariates, there are maternal age (P<0.05), marital status (P<0.05), pre-pregnancy body mass index (P<0.001), preterm birth (P<0.001), pregnancy history (P<0.01), vaginal bleeding (P <0.05), and cervical or vaginal infection (P<0.05).The number of respondents depression scores high risk factors for spontaneous preterm birth twice in non-depressed respondents (odds ratio (OR)=2.1,95%confidence interval (CI):1.1,4.1). While for the analysis of spontaneous preterm birth and associated risk factors derived, which has obvious relevance statistically significant correlation among state anxiety (OR=1.7,95%CI:0.97,2.8) and the correlation between trait anxiety (OR=1.7,95%CI:1.0,2.8).At the same time, we chose depression as the only psychological characteristics associated with risk factors for spontaneous preterm birth correlation analysis, through multiple regression analysis (a multivariate backward analysis), we found that the association is still very statistically significant (adjusted OR=2.0,95%CI:0.99,4.0).Fourth, the study of psychological factors involved in the survey and risk factors associated with spontaneous preterm labor relations.(P=0.052) relationship between depression and BMI before pregnancy (P=0.044), and vaginal bleeding state anxiety and trait anxiety relationship with a history of spontaneous preterm birth (P=0.033). The results showed that depression and low pre-pregnancy body mass index (adjusted OR=6.9,95%CI:1.8,26.2) is closely related to the other two are not related significance..ConclusionFirst, maternal age, marital status, pre-pregnancy body mass index, history of preterm delivery, vaginal bleeding and cervical or vaginal infection was significantly associated with spontaneous preterm birth.Second, the psychological factors of anxiety, depression and closely related to the occurrence of spontaneous preterm birth.Third, depression and low pre-pregnancy body mass index are closely related.