妊娠期女性妊娠压力、孕前保健行为及其应对方式的相关性研究

doi:10.3969/j.issn.1674-8115.2024.08.005

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (8): 968-974.doi: 10.3969/j.issn.1674-8115.2024.08.005

妊娠期女性妊娠压力、孕前保健行为及其应对方式的相关性研究

李婧菱¹(), 徐小艳¹^,², 李静¹, 周倩¹, 高艺¹, 周璇¹, 帅鎣¹, 刘汉梅¹^,²()

^1.遵义医科大学护理学院，遵义 563003
^2.遵义医科大学附属医院护理部，遵义 563003

收稿日期:2023-11-10 接受日期:2024-03-04 出版日期:2024-08-28 发布日期:2024-08-27
通讯作者: 刘汉梅 E-mail:2187131318@qq.com;289974673@qq.com
作者简介:李婧菱（2000—），女，学士；电子信箱：2187131318@qq.com。
基金资助:
贵州省科技计划项目（黔科合成果-LC 2024-024）

Correlation study of pregnancy stress, pre-pregnancy health care behavior and coping style of pregnant women

LI Jingling¹(), XU Xiaoyan¹^,², LI Jing¹, ZHOU Qian¹, GAO Yi¹, ZHOU Xuan¹, SHUAI Ying¹, LIU Hanmei¹^,²()

^1.School of Nursing, Zunyi Medical University, Zunyi 563003, China
^2.Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China

Received:2023-11-10 Accepted:2024-03-04 Online:2024-08-28 Published:2024-08-27
Contact: LIU Hanmei E-mail:2187131318@qq.com;289974673@qq.com
Supported by:
Science and Technology Plan Project of Guizhou Province(QiankeHeChengGuo-LC 2024-024)

摘要/Abstract

摘要：

目的·了解妊娠期女性妊娠压力水平、孕前保健行为及应对方式，分析妊娠压力的影响因素，为妊娠期女性孕期健康管理提供参考。方法·纳入2022年4月—8月在遵义医科大学附属医院产科门诊就诊的265名妊娠期妇女为研究对象，采用一般资料情况问卷、孕前保健行为问卷、妊娠压力量表、简易应对方式问卷，取得患者同意后，调查妊娠期女性妊娠压力、孕前保健行为及应对方式，分析其之间的相关性。结果·妊娠期女性妊娠压力总平均分为（1.05±0.41）分。多元线性回归分析结果显示，年龄、妊娠次数、先兆流产史、对胎儿性别期待、参加孕妇学校或观看相关手册是妊娠压力的主要影响因素（P<0.05）。孕前保健行为得分为（10.09±2.63）分，具备高等、中等、低等水平的妊娠期孕前保健行为人数占比分别为17.36%、54.34%和28.30%。妊娠期女性应对方式总分为（27.22±9.68）分，其中积极应对维度得分为（17.79±9.84）分，消极应对维度得分为（9.42±7.39）分。Pearson相关分析显示，妊娠压力与孕前保健行为呈负相关（r=-0.313，P<0.01），妊娠压力与应对方式呈负相关（r=-0.163，P<0.01），孕前保健行为与应对方式呈正相关（r=0.220，P<0.01）。结论·妊娠期女性妊娠压力处于中度水平，孕前保健行为较少，护理人员应大力加强孕前健康知识普及和保健指导，让育龄期女性孕前主动、积极地学习妊娠相关保健知识和应对技巧，最大程度地减少或避免不良母婴妊娠结局，优化母婴保健策略和提升健康水平。

关键词: 妊娠期, 保健行为, 妊娠压力, 应对方式

Abstract:

Objective ·To assess the levels of pregnancy-related stress, pre-pregnancy health care behaviors, and coping styles among pregnant women,analyze the influencing factors of pregnancy stress and provide insights for the management of pregnancy health in expectant mothers. Methods ·A total of 265 pregnant women receiving treatment at the Obstetrics Clinic of the Affiliated Hospital of Zunyi Medical University from April to August 2022 were included as participants. General information questionnaires, pre-pregnancy health care behavior questionnaires, pregnancy stress scales and simple coping style questionnaires were utilized for data collection. After obtaining the consent of the patients, assessments on pregnancy stress levels, pre-pregnancy health care behaviors, and coping styles were conducted. Results ·The overall average score for pregnancy stress among pregnant women was 1.05±0.41. Multiple linear regression analysis revealed that age, number of pregnancies, history of threatened abortion, fetal gender expectations, attending prenatal education classes or reviewing relevant manuals significantly influenced pregnancy-related stresses (P<0.05). The score of pre-pregnancy health care behavior was 10.09±2.63 with proportions indicating high-level, medium-level, and low-level adherence at 17.36%, 54.34%,and 28.30%. In pregnant women, the total score for coping styles was 27.22±9.68, with a positive coping dimension score of 17.79±9.84 and a negative coping dimension score of 9.42±7.39. Pearson correlation analyses demonstrated a negative association between pregnancy-related stresses and pre-pregnancy health care behaviors (r=-0.313, P<0.01), and a negative correlation between pregnancy-related stresses and coping styles (r=-0.163, P<0.01), while a positive relationship existed between pre-pregnancy health care behaviors and coping styles (r=0.220, P<0.01). Conclusion ·Pregnant women experience moderate levels of pressure during their pregnancies and have suboptimal engagement in preconceptional healthcare practices. Nursing staff should intensify efforts towards disseminating knowledge on preconceptional healthcare practices, thereby empowering women of childbearing age to actively acquire pertinent reproductive-health knowledge prior to conception so that minimizing adverse maternal-infant outcomes, optimizing maternal-infant healthcare strategies, and enhancing overall well-being can be achieved through these measures.

Key words: pregnancy period, health care behavior, pregnancy stress, coping style

中图分类号:

R473.71

李婧菱, 徐小艳, 李静, 周倩, 高艺, 周璇, 帅鎣, 刘汉梅. 妊娠期女性妊娠压力、孕前保健行为及其应对方式的相关性研究[J]. 上海交通大学学报（医学版）, 2024, 44(8): 968-974.

LI Jingling, XU Xiaoyan, LI Jing, ZHOU Qian, GAO Yi, ZHOU Xuan, SHUAI Ying, LIU Hanmei. Correlation study of pregnancy stress, pre-pregnancy health care behavior and coping style of pregnant women[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(8): 968-974.

图/表 5

参考文献 22

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Variable	Participant/n(%)
Age
<19 years	11 (4.2)
≥19 years and <24 years	84 (31.7)
≥24 years and <29 years	101 (38.1)
≥29 years and <34 years	46 (17.3)
≥34 years	23 (8.7)
BMI/(kg·m^-2)
<18.5	42 (15.8)
18.5≤BMI<25.0	164 (61.9)
25.0≤BMI<30.0	42 (15.8)
≥30.0	17 (6.5)
Place of residence
city	164 (61.9)
town	70 (26.4)
village	31 (11.7)
Education
Middle school and below	50 (18.9)
High school	36 (13.6)
College	154 (58.1)
Master and above	25 (9.4)
Occupation
Worker/Farmer	22 (8.3)
Service industry	28 (10.6)
Unemployed or housewife	51 (19.3)
Medical personnel	54 (20.3)
Teacher/civil servant	66 (24.9)
Others	44 (16.6)
Daily sleep time
<6 h	18 (6.8)
≥6 h and <8 h	185 (69.8)
≥8 h	62 (23.4)
Number of pregnancy
First born	187 (70.6)
Second child and above	78 (29.4)
Gestational week
<16 weeks	94 (35.5)
≥16 weeks and <24 weeks	53 (20.0)
≥24 weeks	118 (44.5)
Abortion experience
0 time	170 (64.1)
Spontaneous abortion 1 time	25 (9.4)
Spontaneous abortion 2 or more times	10 (3.7)
Induced abortion 1 time	32 (12.1)
Induced abortion 2 or more	28 (10.7)
History of threatened abortion
Yes	77 (29.1)
No	188 (70.9)
Complications of pregnancy
Pregnancy with hypertensive disease	9 (3.4)
Pregnancy with thyroid dysfunction	29 (10.9)
Gestational diabetes	7 (2.6)
Intrahepatic cholestasis of pregnancy	5 (1.9)
Others	18 (6.8)
No	197 (74.4)
Fetal sex expectation
Male	37 (14.0)
Female	29 (10.9)
Male or female	199 (75.1)
Attending a school for pregnant women or reading the brochure
Often	42 (15.9)
Once in a while	111 (41.9)
No	112 (42.2)
Relatives and friends are medical workers
Yes	162 (61.1)
No	103 (38.9)
Average monthly income/RMB
<2 000	57 (21.5)
≥2 000 and <5 000	96 (36.2)
≥5 000 and <8 000	71 (26.8)
≥8 000	41 (15.5)
Medical insurance method
Employee medical insurance	119 (44.9)
New rural cooperative medical system	67 (25.3)
Commercial insurance	3 (1.1)
Self-financing	76 (28.7)
Maternity school
Yes	153 (57.7)
No	112 (42.3)

Variable	Participant/n(%)
Age
<19 years	11 (4.2)
≥19 years and <24 years	84 (31.7)
≥24 years and <29 years	101 (38.1)
≥29 years and <34 years	46 (17.3)
≥34 years	23 (8.7)
BMI/(kg·m^-2)
<18.5	42 (15.8)
18.5≤BMI<25.0	164 (61.9)
25.0≤BMI<30.0	42 (15.8)
≥30.0	17 (6.5)
Place of residence
city	164 (61.9)
town	70 (26.4)
village	31 (11.7)
Education
Middle school and below	50 (18.9)
High school	36 (13.6)
College	154 (58.1)
Master and above	25 (9.4)
Occupation
Worker/Farmer	22 (8.3)
Service industry	28 (10.6)
Unemployed or housewife	51 (19.3)
Medical personnel	54 (20.3)
Teacher/civil servant	66 (24.9)
Others	44 (16.6)
Daily sleep time
<6 h	18 (6.8)
≥6 h and <8 h	185 (69.8)
≥8 h	62 (23.4)
Number of pregnancy
First born	187 (70.6)
Second child and above	78 (29.4)
Gestational week
<16 weeks	94 (35.5)
≥16 weeks and <24 weeks	53 (20.0)
≥24 weeks	118 (44.5)
Abortion experience
0 time	170 (64.1)
Spontaneous abortion 1 time	25 (9.4)
Spontaneous abortion 2 or more times	10 (3.7)
Induced abortion 1 time	32 (12.1)
Induced abortion 2 or more	28 (10.7)
History of threatened abortion
Yes	77 (29.1)
No	188 (70.9)
Complications of pregnancy
Pregnancy with hypertensive disease	9 (3.4)
Pregnancy with thyroid dysfunction	29 (10.9)
Gestational diabetes	7 (2.6)
Intrahepatic cholestasis of pregnancy	5 (1.9)
Others	18 (6.8)
No	197 (74.4)
Fetal sex expectation
Male	37 (14.0)
Female	29 (10.9)
Male or female	199 (75.1)
Attending a school for pregnant women or reading the brochure
Often	42 (15.9)
Once in a while	111 (41.9)
No	112 (42.2)
Relatives and friends are medical workers
Yes	162 (61.1)
No	103 (38.9)
Average monthly income/RMB
<2 000	57 (21.5)
≥2 000 and <5 000	96 (36.2)
≥5 000 and <8 000	71 (26.8)
≥8 000	41 (15.5)
Medical insurance method
Employee medical insurance	119 (44.9)
New rural cooperative medical system	67 (25.3)
Commercial insurance	3 (1.1)
Self-financing	76 (28.7)
Maternity school
Yes	153 (57.7)
No	112 (42.3)

Variable	Score range	Score
Pregnancy pressure	0‒3	1.05±0.41
Pressure to identify with the role of parent	0‒1.5	0.86±0.34
Stress caused by the health and safety of the mother and child	0‒0.8	1.23±0.61
Stress due to changes in body size and physical activity	0‒0.4	1.35±0.81
Other factors	0‒0.3	1.16±0.80
Preconception health care behavior	0‒15	10.09±2.63
Planned pregnancy	0‒1	0.85±0.36
Medical physiological preparation	0‒5	3.27±1.14
Food, clothing, shelter and transportation	0‒8	5.27±1.73
Rational contraception	0‒1	0.49±0.50
Coping style	0‒60	27.22±9.68
Active way	0‒36	17.79±9.84
Negative way	0‒24	9.42±7.39

Variable	Score range	Score
Pregnancy pressure	0‒3	1.05±0.41
Pressure to identify with the role of parent	0‒1.5	0.86±0.34
Stress caused by the health and safety of the mother and child	0‒0.8	1.23±0.61
Stress due to changes in body size and physical activity	0‒0.4	1.35±0.81
Other factors	0‒0.3	1.16±0.80
Preconception health care behavior	0‒15	10.09±2.63
Planned pregnancy	0‒1	0.85±0.36
Medical physiological preparation	0‒5	3.27±1.14
Food, clothing, shelter and transportation	0‒8	5.27±1.73
Rational contraception	0‒1	0.49±0.50
Coping style	0‒60	27.22±9.68
Active way	0‒36	17.79±9.84
Negative way	0‒24	9.42±7.39

Variable	U/Z	P value
Age	9.759	0.045
BMI	8.957	0.030
Place of residence	7.400	0.025
Average monthly income	21.183	0.000
Number of pregnancies	-3.133	0.002
History of threatened abortion	-6.053	0.000
Complications of pregnancy	11.195	0.048
Fetal sex expectation	28.698	0.000
Attending a school for pregnant women or reading the brochure	54.305	0.000

妊娠期女性妊娠压力、孕前保健行为及其应对方式的相关性研究

Correlation study of pregnancy stress, pre-pregnancy health care behavior and coping style of pregnant women

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图/表 5

参考文献 22

相关文章 15

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Metrics

Variable	B	SD	β	t	P value
Constant	33.527	4.185	‒	8.011	0.000
Age
1=<19 years	8.966	3.480	0.145	2.576	0.011
2=≥19‒24 years	3.776	1.630	0.142	2.317	0.021
3=≥24‒34 years	0.209	1.978	0.006	0.106	0.916
4=≥34 years	2.191	2.602	0.050	0.842	0.401
Number of pregnancies
1=first pregnancy	5.398	1.761	0.199	3.065	0.002
History of threatened abortion
1=have	8.740	1.470	0.321	5.948	0.000
Fetal sex expectation
1=male	7.082	1.998	0.198	3.544	0.000
2=female	0.784	2.112	0.020	0.371	0.711
Attending a school for pregnant women or reading the brochure
1=often	-8.358	1.909	-0.309	-4.379	0.000
2=occasionally	-3.576	1.569	-0.138	-2.280	0.024

Variable	Pregnancy pressure	Preconception health care behavior	Active way	Negative way	Coping style
Pregnancy pressure	1.000	‒	‒	‒	‒
Preconception health care behavior	-0.313^①	1.000	‒	‒	‒
Active way	-0.661^①	0.368^①	1.000	‒	‒
Negative way	0.667^①	-0.201^①	-0.398^①	1.000	‒
Coping style	-0.163^①	0.220^①	0.713^①	0.359^①	1.000

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