Related Factors Of Anxiety In Pregnant Women With Congenital Heart Disease Fetus:a Case-case Control Study

Background:Congenital heart disease is the leading cause of birth defects in China,and is the leading cause of death among children under 5 years.In recent years,with the transformation of medical model to bio psycho social medical model,the mental health of pregnant women has been concerned widely.Previous studies have suggested that the anxiety of pregnant women may have a negative impact on the health of mother and offspring.Objective:We aim to investigate the prevalence of anxiety among mothers with congenital heart disease fetuses,explore the influencing factors related to the anxiety of pregnant women,and provide the basis for medical staffs to follow pregnant women's mental health,provide targeted psychological intervention and perinatal period care.Materials and Methods:Subjects were mothers with congenital heart disease fetuses obtained from the congenital heart disease network platform in Zhejiang province from January 2016 to September 2016.We used self-designed questionnaire and anxiety self-assessment scale(SAS)to study the basic situation,disease history,pregnancy history,type of fetal congenital heart disease,and anxiety score through telephone survey.All the questionnaires were entered into the computer for data cleaning,proofreading and database building.Differences were tested for distributions of risk factors such as mother's residency,occupation,medical history,medication history,pregnancy history,father's disease history,medication history,whether pregnant women consulted the medical staff and so forth.We used Pearson ?2 test to compare with risk factors between anxiety and non-anxiety groups.Those significant factors were included in the multivariate regression model.We calculated the odds ratios(Ors)and 95%confidence intervals(CIs)for the risk factors and anxiety among pregnancy mothers with congenital heart disease fetuses.P<0.05 was considered statistically significant.Results:1.Finally,a total of 403 valid questionnaires were obtained.The average SAS score of pregnant women with congenital heart disease was 55.6±12.25 points.Subjects were divided into two groups based on the SAS score of 50,including non-anxiety group(<50)and anxiety group(?50).There were 173 women(42.9%)in the non-anxiety group,and 230 women(57.1%)in the anxiety group.2.Analysis of anxiety related factors for mothers with congenital heart disease fetuses showed that significant differences were observed for certain factors and anxiety,including maternal age,maternal occupation,adverse pregnancy history,pregnancy parity,whether spouse took antibiotics before inception,whether pregnant women consulted medical personnel,and fetal heartbeat diagnosis(P<0.05).3.Results from Logistic multivariate regression analyses showed that maternal age(OR=1.246),pregnancy pill(OR=4.860),Chinese medicine(OR=2.745),the father suffered from infectious disease before inception(OR=1.860)were risk factors for pregnancy anxiety.Whether pregnant women consulted medical staff after fetal heartbeat diagnosis(OR=0.128)and simple congenital heart disease(OR=0.009)were protective factors.Conclusion:The anxiety status of mothers with congenital heart disease fetuses was associated with maternal age,occupation,whether the pregnant woman consulted medical staff after the diagnosis,and the type of fetal congenital heart disease diagnosed.Mental health problems in pregnant women with congenital heart disease fetus require medical staff and family members' psychological nursing,targeted psychological intervention to eliminate the anxiety and tension of pregnant women.Guidance and intervention for pregnancy outcome of congenital fetus and perinatal nursing are also important.