| Objective:The purpose of this study is to further explore the relationship between pregnancy stress and prenatal depression in urban pregnant women in China,in order to provide scientific basis for promoting mental health of pregnant women during pregnancy based on the status of pregnancy stress and prenatal depression in urban pregnant women.Methods:A cross-sectional study was conducted and a convenient sampling method is adopted.According to the cross-sectional study formula,the sample size of this study was caculated as 800,and the final sample size was 880 cases in order to prevent loss by increasing 10% of the sample sizes on this basis.From May 2018 to October 2018,869 pregnant women who met the inclusion criteria were selected from three tertiary hospitals in Xi'an.A set of instruments were used for study including general information questionnaire(including pregnant women's social demographic data,pregnant health care data and pregnant social relations data),pregnancy stress scale(PSRS)and Edinburgh postpartum depression scale(EPDS).The data were collected when research.Questionnaire survey and analysis were conducted when the subjects went to the designated hospital for pregnant health care.Data analysis software SPSS18.0 and Amos 22.0 are used as data analysis tools,and statistical methods such as generalized linear model,multivariate linear stepwise regression analysis,Spearman correlation analysis,Amos structural equation model are used for data analysis.Results:A total of 880 questionnaires were sent out,869 valid questionnaires were received,with the recovery rate of valid questionnaires was 98.8%.1 The general situationThe subjects of this study ranged in age from 20 to 42(29.29 + 3.71),mainly between 26 and 34 years old(77.6%).The number of third trimester pregnancies was evenly distributed.208(23.9%)early pregnant women,338(38.9%)mid-term pregnancies and 323(37.2%)late pregnancies.Most of the occupations were in public office and public institutions(38.0%),followed by service industry(22.7%)and housewives(9.8%).Pregnant women with reproductive health insurance accounted for 40.2% of the total number.Most of the subjects in this study were planned pregnancy(71.7%)Pregnant women with a history of abortion accounted for a small proportion(18.1%).Most of the pregnant women had good husband-wife relationship(76.6%)and no pregnant women had very poor husband-wife relationship(0%).2 pregnancy stress of pregnant womanIn this study,92.8% of pregnant women had stress,only 7.2% of pregnant women had no stress;most of them had mild stress(75.3%),followed by moderate stress(15.5%)and 2.1% had severe stress.Among them,80.8% of pregnant women had pregnancy stress in dimension 2,and 67.9% of pregnant women had pregnancy stress in dimension 1.Among the specific items of the scale,the highest frequency of positive items(75.8%)was "worrying about the safe delivery of babies" and the lowest frequency was "worrying about the important others not accepting children".Among them,"late pregnancy","drinking during pregnancy","individual business households","fertility insurance","unplanned pregnancy","abortion history","high blood sugar" and "husband-wife relationship" are all influencing factors of pregnancy stress of pregnant women.Among them,"late pregnancy","drinking during pregnancy","unplanned pregnancy","history of abortion","high blood sugar" and "poor relationship between husband and wife" are the risk factors of pregnancy stress,while "individual business households","having reproductive insurance" and "having good knowledge of pregnancy health care" are the protective factors of pregnancy stress.3 antenatal depression of pregnant womanThe total score of prenatal depression was 7.50(+4.61)in pregnant women,and 259(29.8%)of pregnant women scored more than or equal to 10 points.The highest score was "When something went wrong,I would unnecessarily blame myself"(1.23(+0.82)and the lowest score was "I wanted to hurt myself"(0.16(+0.40).The results showed that "maternity insurance","late pregnancy","unplanned pregnancy","abortion history","husband-wife relationship" and "living conditions" were all influencing factors of prenatal depression.Among them,"maternity insurance" and "late pregnancy" are protective factors for prenatal depression of pregnant women;"unplanned pregnancy","history of abortion","poor relationship between husband and wife","living with parents-in-law" are risk factors for prenatal depression of pregnant women.4 The relationship between pregnant stress and antenatal depressionTo explore the correlation between pregnancy stress and prenatal depression by Spearman grade correlation analysis of the difference between pregnancy stress and prenatal depression score.Results Pregnancy stress was positively correlated with prenatal depression.Pregnancy stress mediates the occurrence of prenatal depression.The direct effect of pregnancy stress on prenatal depression was-0.049 after birth insurance,gestational age,planned pregnancy,history of abortion and marital relationship were controlled.Pregnancy stress plays a mediating role in the relationship between maternal birth insurance,gestational age,planned pregnancy,abortion history,marital relationship and prenatal depression.The mediating effects account for 10.47%,14.29%,17.35%,23.68% and 13.64% of the total effects of each factor,respectively.Conclusions :(1)Pregnant women have different degrees of pregnancy pressure during pregnancy,most of which are mild stress.Pregnant women's pregnancy pressure is affected by pregnant women's general social background,pregnant health status and social relations during pregnancy.(2)The detection rate of prenatal depression in pregnant women was 29.8%.The occurrence of prenatal depression was related to pregnant women's general social background,health care during pregnancy and social relations during pregnancy.(3)Pregnancy stress of pregnant women is related to the occurrence of prenatal depression of pregnant women;Pregnancy stress of pregnant women is a mediating factor of prenatal depression of pregnant women. |
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