| Objective:To investigate the anxiety and depression of pregnant women with a history of adverse pregnancy during pregnancy,analyze the influencing factors of pregnancy anxiety and depression,and explore the correlation between adverse pregnancy history and pregnancy anxiety and depression,so as to provide a theoretical basis for the prevention,screening and psychological intervention of pregnancy anxiety and depression of pregnant women with a history of adverse pregnancy in the future.Methods:In this study,pregnant women with adverse maternal history and normal pregnant women who participated in the birth cohort of singleton pregnant women in Wuhan Children’s Hospital from 2017 to 2019 were selected as study subjects.And the demographic information,maternal history information and anxiety and depression scores of pregnant women were collected.The demographic information,maternal history information,and anxiety and depression scores of the two study groups were analyzed through the corresponding data collation and statistical methods.We analyzed the demographic information,maternal history information,generalized anxiety scale scores,and Edinburgh postpartum depression scale scores of the two groups,explored the influence of poor maternal history on pregnant women’s anxiety and depression state.And also analyzed other related factors affecting pregnant women’s anxiety and depression,and finally conducted a stratified discussion and analysis according to two factors: gestational week and age,to verified the correlation between poor maternal history and pregnant women’s anxiety and depression.Results:A total of 1716 pregnant women were included in this study,among which 331 had a history of adverse pregnancy and 1385 had no history of adverse pregnancy,accounting for19.3% and 80.7% of the total study population respectively.In the general population,a total of 440 pregnant women were screened positive for anxiety,and a total of 1276 pregnant women were screened negative for anxiety,with a IVpositive rate of 25.6%.There were 377 pregnant women with positive depression screening and 1339 pregnant women with negative depression screening,with a positive rate of 22.0%.Through univariate analysis of the influencing factors of anxiety and depression in pregnant women,there were statistically significant differences in sleep status,other diseases during pregnancy,pre-pregnancy BMI,cold during pregnancy,vomiting during pregnancy,fever during pregnancy and hypertension during pregnancy(P < 0.05).There were statistically significant differences in sleep status,other diseases during pregnancy,pre-pregnancy BMI,cold during pregnancy,vomiting during pregnancy and other aspects of depression in pregnant women(P < 0.05).The positive rate of anxiety screening in pregnant women with adverse pregnancy history was 28.7%.The positive rate of anxiety screening in pregnant women without adverse pregnancy history was 24.9%,and there was no significant difference between the two groups(P > 0.05).The positive rate of depression screening in pregnant women with adverse pregnancy history was 26.6%.The positive rate of depression screening in pregnant women without adverse pregnancy history was 20.9%,and there was a statistical difference between the two groups(P < 0.05).According to Logistic regression model analysis,when only the variable of adverse pregnancy history was included and confounding factors were not controlled,adverse pregnancy history was a positive risk factor for depression screening in pregnant women(OR=1.373,P < 0.05),and the results were statistically significant.After controlling for age,working status,income status,education level,gestational age,pre-pregnancy BMI confounding factors and sleep status,pregnancy cold,pregnancy vomiting and other diseases confounding factors,adverse pregnancy history was still a positive risk factor for depression screening in pregnant women(OR=1.438,P < 0.05;1.376,P < 0.05),the results were statistically significant.Logistic regression analysis showed that there was no correlation between adverse pregnancy history and positive screening for anxiety in pregnant women.The results of multi-factor Logistic regression analysis on influencing factors of depression in pregnant women stratified by gestational age showed that: Among pregnant women in early and middle pregnancies(< 28 weeks),when only the variable of adverse pregnancy history was included and confounding factors were not controlled,adverse pregnancy history was a positive risk factor for depression screening(OR=1.379,P < 0.05),and the results were statistically significant.After controlling for confounding factors such as age,working status,income status,education level and pre-pregnancy BMI,adverse pregnancy history was also a positive risk factor for depression screening in pregnant women(OR=1.400,P < 0.05),and the results were statistically significant.Among women in late pregnancy(≥ 28 weeks),adverse maternal history was not associated with positive screening for depression,when confounding factors were not controlled for.After controlling for age,working status,income status,education level,pre-pregnancy BMI confounding factors and sleep status,pregnancy cold,pregnancy vomiting and other confounding factors,there was no correlation between adverse pregnancy history and positive screening for depression in pregnant women.The results of multivariate Logistic regression analysis on the influencing factors of depression screening in pregnant women by age stratification showed that among pregnant women of normal age(18≤age< 35 years old),when confounding factors were not controlled,there was a statistical difference between adverse pregnancy history and positive risk factors for depression screening in pregnant women(OR=1.512,P < 0.05).After controlling for working status,income status,education level,gestational age,pre-pregnancy BMI confounding factors and sleep status,pregnancy cold,pregnancy vomiting and other diseases confounding factors,adverse pregnancy history was also a positive risk factor for depression screening in pregnant women(OR=1.487,P < 0.05;1.451,P < 0.05),and the results were statistically significant.Among older pregnant women(≥35 years),adverse maternal history was not associated with positive screening for depression,when confounding factors were not controlled for.After controlling for working status,income status,education level,gestational age,pre-pregnancy BMI confounding factors and sleep status,pregnancy cold,pregnancy vomiting and other confounding factors,there was no correlation between adverse pregnancy history and positive screening for depression in pregnant women.Conclusion : Adverse pregnancy history was an independent risk factor for positive depression screening in pregnant women.Adverse pregnancy history was associated with positive screening for depression among women in early and second trimesters(< 28 weeks)and women of appropriate age(18≤ age < 35 years).There was no statistical significance between adverse pregnancy history and positive screening for anxiety in pregnant women.During pregnancy,we should pay more attention to the emotional state of pregnant women with adverse pregnancy history,timely discover pregnant women with anxiety,depression and other adverse emotions,and take corresponding intervention measures. |
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