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中华妇幼临床医学杂志(电子版) ›› 2017, Vol. 13 ›› Issue (04) : 403 -408. doi: 10.3877/cma.j.issn.1673-5250.2017.04.006

所属专题： 文献；

论著

晚孕期孕妇健康相关生命质量及其影响因素分析
朱萍1, 赵志梅2, 綦小蓉3, 薛清平4, 潘雄飞5,†()   
  1. 1. 610041　成都，四川大学华西公共卫生学院
    2. 650118　昆明，中国医学科学院医学生物学研究所
    3. 610041　成都，四川大学华西第二医院妇产科
    4. 610083　成都医学院公共卫生系
    5. 430030　武汉，华中科技大学同济医学院公共卫生学院
  • 收稿日期:2017-05-02 修回日期:2017-07-05 出版日期:2017-08-01
  • 通信作者: 潘雄飞

Health related quality of life and influencing factors of pregnant women during the third trimester

Ping Zhu1, Zhimei Zhao2, Xiaorong Qi3, Qingping Xue4, Xiongfei Pan5,†()   

  1. 1. West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan Province, China
    2. Institute of Medical Biology Chinese Academy of Medical Sciences, Kunming 650118, Yunnan Province, China
    3. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    4. Department of Public Health, Chengdu Medical College, Chengdu 610083, Sichuan Province, China
    5. School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
  • Received:2017-05-02 Revised:2017-07-05 Published:2017-08-01
  • Corresponding author: Xiongfei Pan
  • About author:
    Corresponding author: Pan Xiongfei, Email:
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引用本文：

朱萍, 赵志梅, 綦小蓉, 薛清平, 潘雄飞. 晚孕期孕妇健康相关生命质量及其影响因素分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2017, 13(04): 403-408.

Ping Zhu, Zhimei Zhao, Xiaorong Qi, Qingping Xue, Xiongfei Pan. Health related quality of life and influencing factors of pregnant women during the third trimester[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(04): 403-408.

目的

探讨晚孕期孕妇健康相关生命质量(HRQoL)状况，并分析其影响因素。

方法

选择2013年10月至2014年2月，于四川大学华西第二医院产科门诊接受产前检查的2 017例晚孕期孕妇为研究对象。采用《SF-36健康调查量表》评价受试者HRQoL状况，对可能影响HRQoL评分的14项因素，包括受试者年龄、民族、受教育程度等进行单因素分析。采用多重线性回归分析，对晚孕期孕妇《SF-36健康调查量表》的生理健康综合测量(PCS)得分和心理健康综合测量(MCS)得分的影响因素进行分析。

结果

①本研究受试者《SF-36健康调查量表》各维度得分分别为，生理功能(PF)得分为(63.0±16.6)分，生理职能(RP)为(51.0±24.6)分，躯体疼痛(BP)为(69.0±18.1)分，总体健康(GH)为(73.5±17.2)分，活力(VT)为(60.9±15.0)分，社会功能(SF)为(75.4±17.5)分，情感职能(RE)为(72.8±26.4)分，精神健康(MH)为(78.2±12.6)分。②受试者HRQoL状况的单因素分析结果显示，不同年龄、人体质量指数(BMI)、住房满意程度及婚姻关系4个影响因素的PCS得分比较，差异有统计学意义(P<0.05)；不同年龄、受教育程度、是否在职、家庭人均年收入、住房满意程度、婚姻关系、婆媳关系及孕期丈夫吸烟8个影响因素的MCS得分比较，差异均有统计学意义(P<0.05)。③多重线性回归分析结果显示，对晚孕期孕妇PCS得分的影响由大到小依次为年龄、住房满意程度及婚姻关系，并且随着年龄越大、对住房及婚姻关系越不满意，其PCS得分越低(均为P<0.05)。对晚孕期孕妇MCS得分的影响由大到小依次为婆媳关系、婚姻关系、住房满意程度、年龄及受教育程度，并且年龄越大、受教育程度越高，其MCS得分越高；而对婆媳关系、婚姻关系及住房越不满意，其MCS得分越低(P<0.05)。

结论

晚孕期孕妇的HRQoL与很多因素相关，可据此采取针对性措施，如提高受教育程度，保持良好的婚姻关系及婆媳关系等，这些将有助于提高晚孕期孕妇HRQoL。

关键词: 生活质量, 调查与问卷, 妊娠末期, 孕妇
Objective

To explore the condition of health related quality of life (HRQoL) and its influencing factors of pregnant women during the third trimester.

Methods

We enrolled 2 017 pregnant women during the third trimester at antenatal clinics of West China Second University Hospital, Sichuan University from October 2013 to February 2014. The Chinese Version of Short Form 36 Health Survey (SF-36) was used to assess the HRQoL. Fourteen possible influencing factors including age, nationality and educational background etc. were analyzed by univariate analysis. Multiple linear regression was conducted to analyze the influencing factors of physical component summary (PCS) score and the mental component summary (MCS) score of SF-36.

Results

①The scores of eight domains of SF-36 were (63.0±16.6) score of physical function (PF), (51.0±24.6) score of role physical (RP), (69.0±18.1) score of bodily pain (BP), (73.5±17.2) score of general health (GH), (60.9±15.0) score of vitality (VT), (75.4±17.5) score of social function (SF), (72.8±26.4) score of role emotion (RE), and (78.2±12.6) score of mental health (MH), respectively. ②Univariate analysis showed that there were significant differences of PCS scores of four domains in SF-36 among pregnant women in terms of age, body mass index (BMI), living condition and marital relationship (P<0.05). There were significant differences of MCS scores of four domains in SF-36 among pregnant women in terms of age, educational background, current working status, annual family income per capita, living condition, marital relationship, relationship between mother-in-law and daughter-in-law, and paternal smoking during pregnancy (P<0.05). ③The multiple linear regression results showed that the age, living condition and marital relationship were associated with the PCS scores of pregnant women during the third trimester in a sequence of decreasing impact. Older age, less satisfaction with living condition and marital relationship were associated with a lower PCS score (P<0.05). Relationship between mother-in-law and daughter-in-law, marital relationship, living condition, age and educational background were associated with the MCS scores in a sequence of decreasing impact. Older age and better educational background were associated with a higher MCS score, while less satisfaction with relationship between mother-in-law and daughter-in-law, marital relationship and living condition were associated with a lower MCS score(P<0.05).

Conclusions

Multiple factors are correlated with the HRQoL at the third trimester of pregnancy. Strategies for improving the HRQoL of pregnant women might need to target these factors, such as improving educational background, maintain good relationships with husband and mother-in-law, and so on.

Key words: Quality of life, Surveys and questionnaires, Pregnancy trimester, third, Pregnant women
表1 影响晚孕期孕妇健康相关生命质量得分的单因素分析结果(分，±s)
影响因素 例数 PCS MCS
得分 检验值 P值 得分 检验值 P值
年龄(岁) ? ? F＝12.208 <0.001 ? F＝7.094 <0.001
? <25 113 37.6±8.0 ? ? 51.7±7.9 ? ?
? ≥25～30 870 38.2±7.0 ? ? 53.3±7.8 ? ?
? ≥30～35 769 37.2±7.5 ? ? 54.4±7.2 ? ?
? ≥35 262 35.1±8.1 ? ? 54.7±7.7 ? ?
BMI(kg/m2) ? ? F＝4.045 0.007 ? F＝0.856 0.463
? <18 10 35.0±10.2 ? ? 57.0±7.7 ? ?
? ≥18～24 474 37.6±7.9 ? ? 53.5±7.7 ? ?
? ≥24～28 1 089 37.7±7.1 ? ? 53.9±7.4 ? ?
? ≥28 435 36.3±7.7 ? ? 53.8±7.9 ? ?
民族 ? ? t＝0.043 0.835 ? t＝2.254 0.133
? 汉族 1 980 37.4±7.5 ? ? 53.8±7.6 ? ?
? 少数民族 33 37.7±7.4 ? ? 55.8±5.8 ? ?
受教育程度 ? ? F＝1.063 0.346 ? F＝9.864 <0.001
? 初中及以下 69 37.3±9.2 ? ? 52.5±8.2 ? ?
? 高中或中专 205 38.1±7.7 ? ? 51.8±7.6 ? ?
? 本科及以上 1 741 37.3±7.4 ? ? 54.1±7.5 ? ?
是否在职 ? ? t＝2.032 0.154 ? t＝8.472 0.004
? 是 1 673 37.3±7.4 ? ? 54.0±7.4 ? ?
? 否 344 37.9±7.9 ? ? 52.7±8.1 ? ?
家庭人均年收入(万元) ? ? F＝0.411 0.745 ? F＝5.771 0.001
? <3 236 37.7±8.3 ? ? 52.1±8.1 ? ?
? ≥3～5 282 37.3±7.4 ? ? 53.7±7.1 ? ?
? ≥5～10 722 37.5±6.9 ? ? 53.7±7.7 ? ?
? ≥10 722 37.2±7.9 ? ? 54.5±7.5 ? ?
生育史 ? ? t＝3.467 0.063 ? t＝0.084 0.772
? 有 294 36.6±7.9 ? ? 53.7±7.6 ? ?
? 无 1 721 37.5±7.4 ? ? 53.8±7.6 ? ?
流产史 ? ? t＝3.416 0.065 ? t＝0.469 0.493
? 有 1 013 37.1±7.7 ? ? 53.7±7.5 ? ?
? 无 1 000 37.7±7.3 ? ? 53.9±7.7 ? ?
此次是否为意外妊娠 ? ? t＝0.138 0.710 ? t＝1.074 0.300
? 是 603 37.3±7.7 ? ? 53.6±7.9 ? ?
? 否 1 413 37.4±7.4 ? ? 54.0±7.4 ? ?
婚姻关系 ? ? t＝6.386 0.012 ? t＝25.831 <0.001
? 满意 2 002 37.4±7.5 ? ? 53.9±7.5 ? ?
? 不满意 13 32.1±10.7 ? ? 43.3±10.9 ? ?
婆媳关系 ? ? F＝1.923 0.146 ? F＝30.617 <0.001
? 满意 1 650 37.5±7.5 ? ? 54.4±7.2 ? ?
? 不满意，但能维持 343 36.6±7.5 ? ? 51.3±8.3 ? ?
? 不满意，并且不能维持 18 37.5±8.0 ? ? 47.4±10.0 ? ?
孕期丈夫吸烟 ? ? t＝0.093 0.760 ? t＝7.805 0.005
? 是 691 37.4±7.6 ? ? 53.2±7.9 ? ?
? 否 1 326 37.3±7.4 ? ? 54.2±7.4 ? ?
孕期丈夫饮酒 ? ? t＝0.644 0.422 ? t＝3.436 0.064
? 是 593 37.2±7.5 ? ? 53.3±7.8 ? ?
? 否 1 423 37.5±7.5 ? ? 54.0±7.5 ? ?
住房满意程度 ? ? F＝8.511 <0.001 ? F＝18.975 <0.001
? 非常满意 266 39.1±7.9 ? ? 55.4±7.6 ? ?
? 满意 1 174 37.2±7.3 ? ? 54.2±7.3 ? ?
? 一般/不满意 567 36.9±7.6 ? ? 52.3±8.0 ? ?
表2 晚孕期孕妇健康相关生命质量影响因素的多重线性回归分析的变量含义及赋值情况
解释变量/结局变量 变量名 赋值
PCS y1 y1表示生理健康综合测量得分
MCS y2 y2表示心理健康综合测量得分
年龄 x1 x1＝1表示<25岁，x1＝2表示≥25～30岁，x1＝3表示≥30～35岁，x1＝4表示≥35岁
受教育程度 x2 x2＝1表示初中及以下，x2＝2表示高中或中专，x2＝3表示本科及以上
婚姻关系 x3 x3＝1表示满意，x3＝2表示不满意
婆媳关系 x4 x4＝1表示满意，x4＝2表示不满意，但能维持，x4＝3表示不满意，并且不能维持
住房满意程度 x5 x5＝1表示非常满意，x5＝2表示满意，x5＝3表示一般/不满意
表3 晚孕期孕妇《SF-36健康调查量表》生理健康综合测量得分影响因素的多重线性回归分析结果
变量 偏回归系数 偏回归系数标准误 标准化偏回归系数 t值 P值
常数项 44.18 3.39 －a 13.020 <0.001
年龄 －0.81 0.24 －0.09 -3.382 0.001
婚姻关系 －4.18 2.10 －0.05 －1.991 0.047
住房满意程度 －0.79 0.28 －0.07 －2.841 0.005
表4 晚孕期孕妇《SF-36健康调查量表》心理健康综合测量得分影响因素的多重线性回归分析结果
变量 偏回归系数 偏回归系数标准误 标准化偏回归系数 t值 P值
常数项 56.63 3.40 －a 16.660 <0.001
年龄 0.89 0.22 0.09 4.090 <0.001
受教育程度 0.93 0.40 0.05 2.297 0.022
婚姻关系 －8.92 2.07 －0.10 －4.319 <0.001
婆媳关系 －2.75 0.41 －0.15 －6.683 <0.001
住房满意程度 －1.26 0.27 －0.10 －4.625 <0.001
[1]
Shishehgar S, Dolatian M, Majd HA, et al. Perceived pregnancy stress and quality of life amongst Iranian women[J]. Glob J Health Sci, 2014, 6(4): 270-277.
[2]
Lau Y. The effect of maternal stress and health-related quality of life on birth outcomes among Macao Chinese pregnant women[J]. J Perinat Neonatal Nurs, 2013, 27(1): 14-24.
[3]
Grigoriadis S, Vonderporten EH, Mamisashvili L, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and Meta-analysis[J]. J Clin Psychiatry, 2013, 74(4): 321-341.
[4]
Farr SL, Dietz PM, Rizzo JH, et al. Health care utilisation in the first year of life among infants of mothers with perinatal depression or anxiety[J]. Paediatr Perinat Epidemiol, 2013, 27(1): 81-88.
[5]
靳文正，虞慧婷. SF-36量表应用于居民自我健康测评的信度和效度研究[J]. 中国卫生资源，2012, 15(3): 265-267.
[6]
Eisenman DP, Gelberg L, Liu H, et al. Mental health and health-related quality of life among adult Latino primary care patients living in the United States with previous exposure to political violence[J]. JAMA, 2003, 290(5): 627-634.
[7]
Liu L, Setse R, Grogan R, et al. The effect of depression symptoms and social support on black-white differences in health-related quality of life in early pregnancy: the health status in pregnancy (HIP) study[J]. BMC Pregnancy Childbirth, 2013, 13: 125.
[8]
Haas JS, Jackson RA, Fuentes-Afflick E, et al. Changes in the health status of women during and after pregnancy[J]. J Gen Intern Med, 2005, 20(1): 45-51.
[9]
Moya J, Phillips L, Sanford J, et al. A review of physiological and behavioral changes during pregnancy and lactation: potential exposure factors and data gaps[J]. J Expo Sci Environ Epidemiol, 2014, 24(5): 449-458.
[10]
Chang SR, Chen KH, Lin MI, et al. A repeated measures study of changes in health-related quality of life during pregnancy and the relationship with obstetric factors[J]. J Adv Nurs, 2014, 70(10): 2245-2256.
[11]
Vinturache A, Stephenson N, McDonald S, et al. Health-related quality of life in pregnancy and postpartum among women with assisted conception in Canada[J]. Fertil Steril, 2015, 104(1): 188-195.
[12]
Geller PA. Pregnancy, an overview[M]. Berlin: Springer Netherlands, 2014: 5030-5033.
[13]
宋爱芹，王申广，李雪梅，等. 已婚育龄妇女生命质量现况调查[J]. 中国行为医学科学，2005, 14(8): 733-734.
[14]
Hama K, Takamura N, Honda S, et al. Evaluation of quality of life in Japanese normal pregnant women[J]. Acta Medica Nagasakiensia, 2008, 52(4): 95-99.
[15]
杨晓敏. 乙肝病毒感染孕妇生活质量及其相关因素研究[D]. 长沙：中南大学，2009.
[16]
周桂菊，王冬梅，孙黎. 高龄经产妇妊娠的临床特征及对妊娠结局的影响[J]. 中国妇幼保健，2016, 31(23): 4971-4973.
[17]
张祥荣. 308例孕妇心理健康状况及其影响因素调查分析[J]. 母婴世界，2015(6): 45-46.
[18]
Lau Y, Yin L. Maternal, obstetric variables, perceived stress and health-related quality of life among pregnant women in Macao, China [J]. Midwifery, 2011, 27(5): 668-673.
[19]
Nicholson WK, Setse R, Hill-Briggs F, et al. Depressive symptoms and health-related quality of life in early pregnancy[J]. Obstet Gynecol, 2006, 107(4): 798-806.
[20]
Jallo N, Bourguignon C, Taylor AG, et al. Stress management during pregnancy: designing and evaluating a mind-body intervention[J]. Fam Community Health, 2008, 31(3): 190-203.
[21]
董金玲. 围生期妇女生命质量及影响因素分析[J]. 齐鲁护理杂志，2011, 17(33): 32-33.
[22]
Calou CGP, Pinheiro AKB, Oliveira MFD, et al. Health related quality of life of pregnant women and associated factors: an integrative review[J]. Health, 2014, 6(18): 2375-2387.
[23]
Abbaszadeh F, Kafaei Atrian M, Masoudi Alavi N, et al. Relationship between quality of life and depression in pregnant women[J]. Nurs Midwifery Stud, 2013, 2(2): 193-197.
[24]
Ali A. Relationship between unwanted pregnancy and health-related quality of life in pregnant women[J]. J Coll Physicians Surg Pak, 2016, 26(6): 507-512.
[25]
Gariepy A, Lundsberg L, Vilardo N, et al. Measuring the impact of pregnancy intention on women′s health-related quality of life[J]. Contraception, 2015, 92(4): 390-391.
[26]
Sahrakorpi N, Koivusalo SB, Eriksson JG, et al. Perceived financial satisfaction, health related quality of life and depressive symptoms in early pregnancy[J]. Matern Child Health J, 2017, 21(7): 1493-1499.
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