Changes in pregnancy-related discomforts in women from the third-trimester pregnancy to 1 year postpartum
Changes in pregnancy-related discomforts in women from the third-trimester pregnancy to 1 year postpartum
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女性从妊娠晚期到产后一年与妊娠相关不适的变化
DOI：
10.3418/jjam.jjam-2020-0007
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
H. Shinkawa
中科院分区：
文献类型：
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作者：
H. Shinkawa
目的探讨妊娠晚期至产后1年期间妊娠相关不适的发生率和频率的变化及其相关因素。方法研究对象为在日本广岛4家医院妇产科门诊就诊的孕妇，她们在医院进行体检或参加产科培训班。问卷调查进行了五次纵向管理：在怀孕期间，在出院，并在1个月，4个月，1年后分娩。调查内容包括29种常见妊娠不适的存在情况及发生频率、分娩方式、喂养情况、育儿负担量表、日本版母亲依恋量表（MAI-J）和日本版爱丁堡产后抑郁量表（EPDS）。我们进行了单因素方差分析，分析从怀孕到产后的症状数量的变化和卡方检验，分析每种症状的患病率。采用皮尔逊积因子相关系数和非配对t检验分析产后症状数与影响产后健康因素的关系。结果共发放问卷1566份，收集681份妊娠晚期资料，使用资料422份。还向下列产后时期的妇女分发了调查表：出院时，126人;产后1个月，88人;产后4个月，79人;产后1年，70人。妊娠相关症状随时间延长而减少（F=130.93，p<0.01）。分娩后22种症状的患病率显著下降，而3种症状的患病率增加，4种症状的患病率保持不变。出院时和产后1个月症状数与产后1个月~ 1年EPDS评分（r=0.39-0.58，p<0.01）和育儿负担量表（r=0.30-0.44，p<0.05）显著相关。结论部分妊娠相关不适症状持续至产后，产后症状的出现次数与产后抑郁及产后护理压力有关。因此，我们表明了怀孕期间产妇护理的重要性，因为它影响到以后的育儿。育儿从怀孕开始。因此，只有不轻视与怀孕有关的不适，如“小麻烦”，才有可能顺利过渡到育儿，因为妇女从怀孕开始就需要所有的身体、精神和情感护理，以便在产后阶段的各个方面保持强壮和健康。
Purpose The present study aimed to clarify the changes in the incidence and frequency of pregnancy-related discomforts in the period from the third-trimester pregnancy to 1 year postpartum, and factors associated with the symptoms. Methods The participants were pregnant women who visited the obstetrics and gynecology outpatient departments of four hospitals for medical examinations or maternity classes in Hiroshima, Japan. A questionnaire survey was administered five times longitudinally: during the pregnancy period, at discharge, and at 1 month, 4 months, and 1 year after childbirth. The contents of the survey consisted of the existence and the frequency of 29 frequently experienced discomforts of pregnancy, type of delivery, feeding condition, childcare burden scale, Japanese version of maternal attachment inventory (MAI-J), and Japanese version of Edinburgh postnatal depression scale (EPDS). We performed one-way analysis of variance for analyzing the changes in the number of symptoms from pregnancy to postpartum and chi-square tests for analyzing the prevalence of each symptom. The Pearson product factor correlation coefficient and unpaired t-tests were used for analyzing the relation between the number of symptoms and the factors affecting postpartum health. Results Questionnaires were distributed to 1566 women in the pregnancy period, and we collected third-trimester data of 681 women and used data of 422 women. Questionnaires were also distributed to the women during the following postpartum periods: time of discharge, 126; 1 month after childbirth, 88; 4 months after childbirth, 79; and 1 year after childbirth, 70. The number of pregnancy-related symptoms were decreased as time passed by (F=130.93, p<0.01). The prevalence of 22 symptoms significantly decreased after childbirth, while the prevalence of three symptoms increased and that of four symptoms remained unaltered. The number of symptoms at the time of discharge and 1 month after childbirth were significant correlated with the EPDS score (r=0.39–0.58, p<0.01) and the childcare burden scale (r=0.30–0.44, p<0.05) from 1 month to 1 year after childbirth. Conclusion The findings of this study confirm that some pregnancy-related discomforts continue to postpartum and that the number of symptoms in postpartum is associated with postpartum depression and the stress of postnatal care. We thus showed the importance of maternal care during pregnancy as it affects childcare later on. Childcare starts from pregnancy. Thus, a smooth transition to childcare is possible only if pregnancy-related discomforts such as “minor troubles” are not taken lightly, as women require all the physical, mental, and emotional care right from the beginning of pregnancy to be strong and healthy in all aspects of the postnatal phase.