Abstract:

Objective To explore the effects of anxiety on pregnant women in the first and third trimesters on delivery modes,in order to improve the labor outcomes. Methods Maternal data from November 2017 to June 2019 in the Obstetrics and Gynecology Hospital of Fudan University information system were extracted after psychological assessment of pregnant women in the first or third trimester. An anxiety group and a non-anxiety group were divided according to the Generalized Anxiety Disorder Scale（GAD-7scale）,and the delivery modes of 2 groups with propensity score matching were compared. Results After propensity score matching,447 pairs of anxiety groups and non-anxiety groups in early trimesters and 53 pairs in late trimesters were successfully matched;there was no significant difference in delivery modes between anxiety groups and non-anxiety groups in early trimesters（ χ ²=1.620,P=0.203）;there were significant differences in delivery modes between anxiety groups and non-anxiety groups in late trimesters（ χ ²=4.330,P=0.037）. Pregnant women in the anxiety group tended to choose cesarean section. Conclusion Results showed that anxiety in the first trimester had no effect on the choice of delivery modes,but anxiety in the third trimester might increase the incidence of cesarean section. It is suggested that cesarean section rates can be reduced by alleviating anxiety in the third trimester,so as to improve the labor outcomes.

Key words: Pregnancy, Anxiety, Delivery Mode, Cesarean Section, Propensity Score Matching, Obstetrical Nursing

摘要：

目的 探索孕早期和孕晚期焦虑状态对产妇分娩方式的影响,旨在改善产妇分娩结局。 方法 提取上海市某妇产科医院信息系统中2017年11月—2019年6月孕早期或孕晚期孕妇心理评估的资料,根据广泛性焦虑量表得分分为焦虑组和非焦虑组,进行倾向性评分匹配后对两组的分娩方式进行比较。 结果 经过倾向性评分匹配,成功配对孕早期孕妇焦虑组-非焦虑组447对,孕晚期孕妇焦虑组-非焦虑组53对。孕早期孕妇焦虑组与非焦虑组间分娩方式比较,差异无统计学意义（ χ ²=1.620,P=0.203）;孕晚期孕妇焦虑组与非焦虑组间分娩方式比较,差异具有统计学意义（ χ ²=4.330,P=0.037）,焦虑组孕妇倾向于选择剖宫产术。 结论 孕早期焦虑对是否选择剖宫产术无影响,而孕晚期焦虑可能会导致产妇选择剖宫产术,可通过降低孕晚期焦虑来降低产妇剖宫产率,从而改善产妇分娩结局。

关键词: 妊娠, 焦虑, 分娩方式, 剖宫产术, 倾向性评分匹配, 产科护理