Study On The Developmental Trajectory And Influencing Factors Of Fmale Depression During Pregnancy And Childbirth Based On The LCGM

Objective: Women during the special period of pregnancy is very prone to depression,depression is very big to the harm of pregnant women and fetus,research shows that different periods of depression incidence is different,the development of the depression group heterogeneity and individual differences exist,therefore identify potential categories of women in the process of maternal depression,and analyzes different categories of potential development path and group heterogeneity,and the influence of trajectory and influence depression group classification factors,maternal depression at home and abroad will provide a scientific basis for prevention and treatment is necessary.Method: Selection on March 1,2018-January 31,2019 in chongqing YuBei,metro,YunYang maternal and child health care and dianjiang county people's hospital for pregnancy check pregnant women,throughinto the exclusion criteria a total of 417 pregnant women as the research object,using the depression self rating scale(SDS)evaluation pregnant early,mid,and late pregnancy and postpartum depression.Software mplus7.0 was used to build a mixed model of latent category growth,to explore the characteristics of depression development trajectory in pregnant women,and the results of subpopulation classification were used as the dependent variable for multivariate logistic regression to explore the influencing factors of subpopulation classification.Result :The study included 417 pregnant women.The results of the latent category growth model show that linear,quadratic and free estimation methods are used to estimate the potential category growth model.According to the model information index,quadratic estimates and free estimate two categories VLRT and BLRT values are less than 0.05,and BIC value is small,but Entropy classification precision index is 0.929 better than the quadratic estimates 0.924,therefore with fixed time points compared to the linear and nonlinear quadratic growth,freedom of the estimated latent class growth model fitting better comprehensive effect.In the two subgroups of the development trajectory of maternal depression,the proportion of 347 in the first group was the largest,and that of 70 in the second group was 83% and 17%,respectively.The corresponding intercept estimates were 0.309(p<0.01)and 0.397(p<0.01),indicating that the initial depression level(intercept)of category ii washigher than that of category I.Category group 1 to the low level of initial,relatively stable trajectory measurement,four times in the first three measurement has a slow downward trend,but not significant(P > 0.05),from the scale of change self-reported depression scores in depression score no depression symptoms(0-0.5)interval,and relatively stable,so the people named the low risk of depression group.Category in group 2,trajectory with time gradually increased,and then in the fourth measurement in the postpartum period,and in the depression score close to0.5 points(mild depression),and in the period before the depression in labor maximum fluctuation margin,with this kind of crowd in maternal depression have a higher risk,so named "high-risk group of depression".There were statistically significant differences between those with or without depression and those with high risk of depression(P<0.05).Age,occupation,educational level,family average per capita monthly income,the presence of maternal history of independence,pregnant childbirth knowledge level,pregnant women,pregnancy stress,anxiety,family care during pregnancy,11 factors such as social support and depression respectively the classification of the trajectory and the group high-risk group and low risk of depression group(depression)do single factor analysis,chi-square test result shows that: there is a pregnancy stress,anxiety,pregnancy care family,social support degrees of four factors and the track of development of the pregnant women during pregnancy andpostpartum depression the proportion of the group classification statistically significant difference(P < 0.05).Pregnant maternal depression trajectory and the group as the dependent variable,with single factor analysis of whether there is a pregnancy stress,anxiety,family care,pregnancy,social support and family per capita income as the independent variable,the multi-factor Logistic regression analysis,using stepwise method for variable selection,results show that the low degree of family care,pregnancy stress,anxiety symptoms during pregnancy is pregnant maternal depression trajectory influence factors of the group classification(P < 0.05),OR(95%CL)values were 2.363(1.279-4.364),6.068(2.418-15.226)and 13.190(5.725-30.390),respectively.Conclusion: There is group heterogeneity in the development trend of depression in pregnant women during pregnancy,which can be divided into "high-risk group of depression" and "low-risk group of depression".Pregnancy anxiety and pregnancy-related stress are the risk factors for pregnant women at high risk of depression.Health care workers and pregnant women should be strengthened to value their family maternal mental health for the pregnant woman to pregnant women to have psychological abnormal psychological intervention as soon as possible,to give more care and help,improve the social support for pregnant women,to improve the pregnancy stress and anxiety and other adversepsychological is an effective way to reduce the maternal women at risk of depression.