地震丧子对再生育妇女月经和心理的影响
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摘要
目的:探讨地震中丧失孩子需要再生育妇女在月经和心理方面的影响。方法:以汶川地震极重灾区197例再生育妇女为研究对象(极重灾区再生育组),对照组为276例极重灾区无重大丧失的妇女(极重灾区对照组)和296例非灾区妇女(非灾区对照组)。研究对象均符合纳入标准,完成人口学、健康行为、月经史和生育史的问卷调查,并对自己的心理状态做出评估——焦虑自评量表(SAS)和抑郁自评量表(SDS)。结果:极重灾区再生育组月经周期异常发生率为32.49%(64/197),经量减少发生率为16.75%(33/197),均显著高于该人群在地震前的发生率(P<0.05),显著高于极重灾区对照组和非灾区对照组(P<0.05)。极重灾区再生育组SAS标准分总均分为52.66±6.05,SDS标准分总均分为68.09±16.78,均显著高于极重灾区对照组和非灾区对照组(P<0.05);其中有44.7%(88/197)的再生育妇女处于焦虑状态,91.9%(181/197)处于抑郁状态,均显著高于极重灾区对照组和非灾区对照组(P<0.05)。logistic回归分析显示,地震后月经周期异常与亲历地震、在地震中丧失孩子、地震后焦虑状态和地震后抑郁状态有关。结论:地震对在地震中丧失孩子需要再生育的妇女在月经和心理方面产生了很大影响。
Objective:To explore the influence of earthquake on menstruation and psychological well-being in women who lost their children in the Wenchuan earthquake and intended to conceive again.Methods:197 women who alive through the earthquake but lost their children and wished to conceive again were recuited as the study group,276 women who didn't lost any important property in the earthquake were chosen as control group one,296 women who lived away the earthquake area were recuited as control group two.All participants completed a questionnaire involving demographic characteristics,health behaviors,menstruation and reproductive histories,they also self-evaluated their psychological well-being according to Zung Self-rating Anxiety Scales(SAS) and Zung Self-rating Depression Scales(SDS).Results:In the study group,the abnormal menstruation rate was 32.40%(64/197),the occurrence rate of oligomenorrhea was 16.75%(33/197),which were much higher than those for the same group before the earthquake(P<0.05),also much higher than those in two control groups(P<0.05).The mean standard scores of SAS and SDS in the study group were 52.66±6.05 and 68.09±16.78,which were both significantly higher than those in the two control groups(P<0.05).In study group,44.7%(88/197) women were in the status of anxiety and 91.9%(181/197) women had depression,which were also significantly higher than those in the two control groups(P<0.05).Logistic regression analysis showed that there were strong corelation between abnormal menstruation after the earthquake and the awareness of the earthquake,child loss in the earthquake,as well as an experience of anxiety and depression.Conclusions:Earthquake had an intense impact on menstruation and psychological well-being in women who were alive through the earthquake but lost their children and expected to conceive again.
Objective:To explore the influence of earthquake on menstruation and psychological well-being in women who lost their children in the Wenchuan earthquake and intended to conceive again.Methods:197 women who alive through the earthquake but lost their children and wished to conceive again were recuited as the study group,276 women who didn't lost any important property in the earthquake were chosen as control group one,296 women who lived away the earthquake area were recuited as control group two.All participants completed a questionnaire involving demographic characteristics,health behaviors,menstruation and reproductive histories,they also self-evaluated their psychological well-being according to Zung Self-rating Anxiety Scales(SAS) and Zung Self-rating Depression Scales(SDS).Results:In the study group,the abnormal menstruation rate was 32.40%(64/197),the occurrence rate of oligomenorrhea was 16.75%(33/197),which were much higher than those for the same group before the earthquake(P<0.05),also much higher than those in two control groups(P<0.05).The mean standard scores of SAS and SDS in the study group were 52.66±6.05 and 68.09±16.78,which were both significantly higher than those in the two control groups(P<0.05).In study group,44.7%(88/197) women were in the status of anxiety and 91.9%(181/197) women had depression,which were also significantly higher than those in the two control groups(P<0.05).Logistic regression analysis showed that there were strong corelation between abnormal menstruation after the earthquake and the awareness of the earthquake,child loss in the earthquake,as well as an experience of anxiety and depression.Conclusions:Earthquake had an intense impact on menstruation and psychological well-being in women who were alive through the earthquake but lost their children and expected to conceive again.
引文
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[2]王丽娜,乔杰.地震灾区妇女再生育策略[J].实用妇产科杂志,2009,25(1):11-12.
[3]Lang Qin,Shan Luo,Xiaohong Li,et al.Fertility assistance program following the Sichuan earthquake in China[J].International Journal of Gynecology and Obstetrics,2009,(104):182-183.
[4]Lihong Geng,Weihong Li,Xiaohong Li,et al.Controlled ovarian hy-perstimulation interventions in infertile women aged40years or older undergoing in vitro fertilization[J].International Journal of Gynecolo-gy and Obstetrics,2009,(106):193-197.
[5]黄薇,朱慧莉.地震灾害对妇女月经的影响[J].实用妇产科杂志,2009,25(1):7-9.
[6]Liu S,Han H,Xiao D,et al.A report on the reproductive health of women after the massive2008Wenchuan earthquake[J].Internation-al Journal of Gynecology and Obstetrics,108(2):161-164.
[7]Hannoun AB,Nassar AH,Usta IM,et al.Effect of war on the men-strual cycle[J].Obstet Gynecol,2007109(4):929-932.
[8]黄雪花,梁雪梅,张建承.汶川大地震幸存者心理健康状况调查研究[J].华西医学,2009,24(4):1003-1005.
[9]赵高锋,杨彦春,张树森,等.汶川地震极重灾区780名受灾群众心理状况调查[J].中国循证医学杂志,2008,8(10):815-819.
[10]王相兰,陶炯,温盛霖,等.汶川地震灾民的心理健康状况及影响因素[J].中山大学学报(医学科学版),2008,29(4):367-371.
[11]孙源泉,范一鸣,王鹏,等.震区丧亲儿童羞怯、创伤后应激障碍症状和心理健康之间的关系[J].中国临床心理学杂志,2009,17(4):484-486.
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