二次妊娠产妇抑郁症状与维生素D缺乏的相关性及对妊娠结局的影响
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摘要
目的:探讨二次妊娠产妇抑郁症状与维生素D缺乏的相关性及其对妊娠结局的影响。方法:选取2012年1月至2016年12月于我院接受诊治并于我院分娩的264例妊娠产妇作为研究对象,采用回顾性分析法分析所有妊娠者的临床资料,根据其资料结果中妊娠次数将其分为首次妊娠组114例和二次妊娠组150例,记录所有妊娠者的焦虑抑郁状况以及维生素D的水平以及妊娠结局,分析二次妊娠产妇抑郁症状与维生素D缺乏的相关性以及其对妊娠结局的影响。结果:(1)二次妊娠产妇其SAS和HAMD评分均较首次妊娠产妇高(F=54.32,146.54;P<0.001),维生素D水平前者较后者低(F=49.94,P<0.001),且二次妊娠产妇其剖宫产发生率明显较高(χ~2=7.216,P=0.024);(2)经Spearman等级相关分析得SAS与HAMD评分与维生素D水平均存在着密切联系,且均呈负相关关系(r=-0.0.420,-0.458;P<0.05);(3)经非条件多因素logistic回归模型分析证实得SAS和HAMD评分较高和维生素D水平过低均为影响二次妊娠产妇其妊娠结局的的独立危险因素,分别为(R~2=1.76,95%CI:1.06~2.95;R~2=1.84,95%CI:1.06~3.22;R~2=1.80,95%CI:1.02~3.17)。结论:二次妊娠伴有抑郁产妇其维生素D水平较低,且维生素D缺乏为导致二次妊娠产妇不良妊娠结局的危险因素。
Objective:To investigate the correlation between depression symptoms and vitamin D deficiency in twice pregnant women and its influence on pregnancy outcome.Methods:A total of 264 pregnant women who were diagnosed and treated in our hospital from January 2012 to December 2016 were selected as the subjects,and the clinical data of all pregnant women were analyzed by retrospective analysis,according to the data,the number of pregnancies was divided into 114 cases in the first pregnancy group and 150 cases in the two pregnancy group;The anxiety and depression status,vitamin D levels and pregnancy outcomes in all pregnancies were regarded and the correlation between depression symptoms and vitamin D deficiency in twice pregnant women and its influence on pregnancy outcome were analyzed.Results:(1)The SAS and HAMD scores of the twice pregnant women were higher than those of the first pregnant women(F=54.32,146.54;P<0.001),the level of vitamin D was lower in the former than that in the latter(F=49.94,P<0.001),and the incidence of cesarean section was higher in the twice pregnant women(χ~2=7.216,P<0.05);(2)SAS and HAMD scores were closely related to vitamin D and water levels by Spearman rank correlation analysis,and they were negatively correlated with each other,which were(r=-0.0.420,-0.458;P<0.05);(3)Multivariate non conditional logistic regression model analysis showed that SAS and HAMD scores of high and low levels of vitamin D were the independent risk factors for pregnancy outcome(Rr=1.76,95%CI:1.06~2.95;Rr=1.84,95%CI:1.06~3.22;Rr=1.80,95%CI:1.02~3.17).Conclusion:The vitamin D levels of secondary pregnancy with depressed maternal is low,and the vitamin D deficiency is a risk factor for adverse pregnancy outcomes of the second pregnancy maternal.
Objective:To investigate the correlation between depression symptoms and vitamin D deficiency in twice pregnant women and its influence on pregnancy outcome.Methods:A total of 264 pregnant women who were diagnosed and treated in our hospital from January 2012 to December 2016 were selected as the subjects,and the clinical data of all pregnant women were analyzed by retrospective analysis,according to the data,the number of pregnancies was divided into 114 cases in the first pregnancy group and 150 cases in the two pregnancy group;The anxiety and depression status,vitamin D levels and pregnancy outcomes in all pregnancies were regarded and the correlation between depression symptoms and vitamin D deficiency in twice pregnant women and its influence on pregnancy outcome were analyzed.Results:(1)The SAS and HAMD scores of the twice pregnant women were higher than those of the first pregnant women(F=54.32,146.54;P<0.001),the level of vitamin D was lower in the former than that in the latter(F=49.94,P<0.001),and the incidence of cesarean section was higher in the twice pregnant women(χ~2=7.216,P<0.05);(2)SAS and HAMD scores were closely related to vitamin D and water levels by Spearman rank correlation analysis,and they were negatively correlated with each other,which were(r=-0.0.420,-0.458;P<0.05);(3)Multivariate non conditional logistic regression model analysis showed that SAS and HAMD scores of high and low levels of vitamin D were the independent risk factors for pregnancy outcome(Rr=1.76,95%CI:1.06~2.95;Rr=1.84,95%CI:1.06~3.22;Rr=1.80,95%CI:1.02~3.17).Conclusion:The vitamin D levels of secondary pregnancy with depressed maternal is low,and the vitamin D deficiency is a risk factor for adverse pregnancy outcomes of the second pregnancy maternal.
引文
[1]Gotaro Kojima M D,Marianne Tanabe M D,Kamal Masaki M D,et al.Association between depressive symptoms and vitamin Ddeficiency in recently admitted nursing home residents[J].Journal of the American Geriatrics Society,2016,64(4):893-895
[2]沈紫丹,程红,彭文,等.产前抑郁患者妊娠结局及其与维生素D缺乏的相关性[J].华南国防医学杂志,2016,34(2):96-98
[3]吴桐,向菲,欧亚萍,等.孕妇血清维生素D水平与妊娠结局的相关性研究[J].重庆医学,2016,45(7):893-895
[4]毕岚,金龙妹,崔巍.300例产妇焦虑、抑郁状况和心理保健需求调查[J].中国健康心理学杂志,2014,22(11):1634-1636
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[6]童成贤,刘津,徐德平,等.妊娠期糖尿病产妇焦虑和抑郁情绪对妊娠结局的影响[J].国际精神病学杂志,2016,43(1):178-182
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[8]叶圣龙,赵久波,许梦迪.生命意义感在孕妇人格和妊娠焦虑关系中的中介效应[J].中国健康心理学杂志,2016,24(4):584-589
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[10]张玮,魏建涛,陈小兰,等.妊娠期维生素D水平与母婴结局的相关性[J].医学临床研究,2017,34(2):300-302
[11]程利南,ChengLinan.孕期增补维生素C对妊娠结局的影响[J].中华全科医师杂志,2016,15(3):239-240
[12]马娟,何玉洁.维生素D与人类生殖关系的研究现状[J].中国临床研究,2015,28(10):1388-1391
[13]廖媚,龙建,崔咏怡,等.广州妊娠期糖尿病孕妇生活事件与孕妇心理健康状况的关系[J].中国健康心理学杂志,2017,25(3):336-339
[14]胡健蓉,徐健红,黄小霞.妊娠期肝内胆汁淤积症患者外周血中维生素D水平及维生素D受体的表达相关性研究[J].中国优生与遗传杂志,2015,23(2):56-58
[15]Park J H,Karmaus W,Zhang H.Prevalence of and risk factors for depressive symptoms in korean women throughout pregnancy and in postpartum period[J].Asian Nursing Research,2015,9(3):219-225
[2]沈紫丹,程红,彭文,等.产前抑郁患者妊娠结局及其与维生素D缺乏的相关性[J].华南国防医学杂志,2016,34(2):96-98
[3]吴桐,向菲,欧亚萍,等.孕妇血清维生素D水平与妊娠结局的相关性研究[J].重庆医学,2016,45(7):893-895
[4]毕岚,金龙妹,崔巍.300例产妇焦虑、抑郁状况和心理保健需求调查[J].中国健康心理学杂志,2014,22(11):1634-1636
[5]王丽萍,黄金.孕期维生素D水平与不良妊娠结局相关性研究进展[J].实用医学杂志,2015,31(20):3446-3448
[6]童成贤,刘津,徐德平,等.妊娠期糖尿病产妇焦虑和抑郁情绪对妊娠结局的影响[J].国际精神病学杂志,2016,43(1):178-182
[7]方敏,冯虹.产次对妊娠期并发症及妊娠结局的影响[J].中国生育健康杂志,2016,27(4):352-354
[8]叶圣龙,赵久波,许梦迪.生命意义感在孕妇人格和妊娠焦虑关系中的中介效应[J].中国健康心理学杂志,2016,24(4):584-589
[9]余菲.妊娠妇女孕中后期维生素D缺乏对婴儿体格生长及智力发育的影响[J].保健医学研究与实践,2017,14(2):20-22
[10]张玮,魏建涛,陈小兰,等.妊娠期维生素D水平与母婴结局的相关性[J].医学临床研究,2017,34(2):300-302
[11]程利南,ChengLinan.孕期增补维生素C对妊娠结局的影响[J].中华全科医师杂志,2016,15(3):239-240
[12]马娟,何玉洁.维生素D与人类生殖关系的研究现状[J].中国临床研究,2015,28(10):1388-1391
[13]廖媚,龙建,崔咏怡,等.广州妊娠期糖尿病孕妇生活事件与孕妇心理健康状况的关系[J].中国健康心理学杂志,2017,25(3):336-339
[14]胡健蓉,徐健红,黄小霞.妊娠期肝内胆汁淤积症患者外周血中维生素D水平及维生素D受体的表达相关性研究[J].中国优生与遗传杂志,2015,23(2):56-58
[15]Park J H,Karmaus W,Zhang H.Prevalence of and risk factors for depressive symptoms in korean women throughout pregnancy and in postpartum period[J].Asian Nursing Research,2015,9(3):219-225