目的 调查分析上海市浦东新区孕产妇的心理健康状况和保健需求,探索建立科学的孕产妇心理健康管理体系.方法 选取2021年4-6月在浦新东区建立《上海市孕产妇保健手册》、符合纳入标准的孕产妇1 026例,采用妊娠压力量表、广泛性焦虑量表(GAD-7)和爱丁堡产后抑郁量表(EDPS)评定孕期和产褥期的心理健康状况;并通过自行设计的《浦东新区孕产妇心理健康管理模式研究调查问卷》,了解影响孕产妇心理健康的相关因素及保健需求.结果 孕期压力检出率为31.9%,焦虑检出率为13.94%,抑郁检出率为15.20%;产褥期焦虑检出率为11.86%,抑郁检出率为14.47%.孕期遇到问题是孕期焦虑的危险因素,孕期遇到烦恼时向关系极为密切的1~2个人倾诉及主动倾诉是孕期焦虑的保护因素.丈夫职业是农林运输无业等、孕期遇到问题是孕期抑郁的危险因素.孕期工作是孕期抑郁的保护因素.有不良生育史是产褥期焦虑的危险因素,婚姻状态为已婚、妊娠风险预警为黄色或红色/橙色/紫色是产褥期焦虑的保护因素.孕产妇户籍为外地且无居住证是产褥期抑郁的危险因素,孕产妇孕期上班、妊娠风险预警为红色/橙色/紫色是产褥期抑郁的保护因素.结论 上海市浦东新区孕产妇孕期、产褥期焦虑、抑郁发生率较高,建立科学的孕产妇心理健康管理体系将有利于提高孕产妇的心理健康水平.
Objective To survey the maternal mental health status and health care needs of pregnant and puerperal women in Shanghai Pudong New Area.Methods A survey on mental health status was conducted among 1 026 pregnant and puerperal women in Shanghai Pudong New Area from April to June 2021.The Pregnancy Pressure Scale,the Generalized Anxiety Disorder Scale(GAD-7)and the Edinburgh Postnatal Depression Scale(EDPS)were applied in the survey.A self-designed questionnaire on maternal mental health management model was used to analyze the factors affecting maternal mental health and health care needs of the pregnant women.Results The survey showed that 31.9%,13.94%and 15.20%of participants had stress,anxiety or depression during pregnancy;and 11.86%and 14.47%of participants had anxiety and depression during puerperium,respectively.Encountering problems and unwillingness to talk about problems and troubles were risk factors for anxiety during pregnancy.Husbands being engaged in agriculture and transport occupation or not having a job and encountering problems were risk factors for depression during pregnancy.Working during pregnancy were protective factors for depression during pregnancy.Abnormal childbearing history,unmarried/divorced/widowed status,being evaluated as green by"Pregnancy Risk Assessment Form for Pregnant Women"were risk factors for postpartum anxiety.Continuing to work after pregnancy was a protective factor;non-local residents or not having residence permits,being evaluated as green by"Pregnancy Risk Assessment Form for Pregnant Women"and depression during pregnancy were risk factors for postpartum depression.Conclusion The incidence of anxiety and depression among pregnant and puerperal women in Pudong New Area of Shanghai is high.The psychological health management system for pregnant and puerperal women will be beneficial to improving their mental health level.