目的 探讨先兆早产孕妇心理压力、唾液皮质醇对早产的影响.方法 2016年1月至9月,采用便利取样法,选取本市某三级甲等专科医院产科先兆早产孕妇138例,按其是否早产分为早产组86例,足月组52例.应用压力感知量表(perceived stress scale,PSS)评估孕妇的心理压力和检测孕妇唾液皮质醇水平.了解先兆早产孕妇的心理压力及唾液皮质醇水平,并采用logistic回归分析孕妇心理压力、 唾液皮质醇与早产的关系.结果 入院时138例孕妇PSS得分(21.5±8.1)分,处于中高水平,但早产组孕妇PSS得分明显高于足月组,组间比较,差异有统计学意义(P<0.05);早产组孕妇8:00am、16:00pm、23:00pm唾液皮质醇均明显高于足月分娩组(均P<0.001).Logistic回归分析结果显示:PSS得分高和先兆流产孕周早是先兆早产孕妇发生早产的独立危险因素(均P<0.05).结论 心理压力大和先兆流产孕周早是预测先兆早产孕妇早产的危险因素.医护人员可通过改善先兆早产孕妇的心理压力状况,从而降低早产的发生率.%Objective To explore the effect of psychological stress and salivary cortisol on the pregnancy outcome of pregnant women with preterm birth. Methods From January to September 2016, the convenience sampling method was adopted to select 138 pregnant woman with preterm preterm delivery of preterm preterm births in a class of grade 3 obstetrics and gynecology specialized hospitals. Among them, there were 86 pregnant women with preterm birth and 52 with full-term birth. The perceived stress scale ( PSS) combined with saliva cortisol testing to assess subjective and objective psychological stress of pregnant women, using multiple linear regression analysis the relationship of psychological pressure,salivary cortisol and preterm birth. Results The PSS score of 138 prenant woman was 21.5±8.1 with middle-high level. The PSS score of 86 pregnant women with preterm birth were higher those of 52 with full-term birth. The salivary cortisol levels of 8:00am, 16:00pm and 23:00pm in 86 pregnant women with preterm birth were respectively significantly higher than those of 52 with full-term birth (P<0.001). Multiple linear regression analysis showed that high PSS score and short pregnant weeks with preterm birth were also risk factors for premature birth (all P<0.05). Conclusions High levels of psychological stress and short pregnant weeks are risk factors for premature birth. Health care workers can reduce the incidence of preterm labor by improving the mental state of pregnant women.
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