Abstract:

Objective To understand the severity and distress of late pregnancy symptoms in elderly primiparas and identify the distribution characteristics of their symptom groups and analyze their influencing factors，so as to provide reference for the development of symptom management practice. Methods Elderly primiparas who met the criteria were investigated by a self-designed general data questionnaire and a self-assessment questionnaire for symptoms of pregnant women in the third trimester in a women’s and children’s hospital in Ningxia. Symptom groups were extracted by exploratory factor analysis，and multiple linear regression analysis was used to determine the influencing factors. Results A total of 217 valid questionnaires were collected. The six symptoms with the highest incidence were lumbago （87.1%），frequent urination （84.8%），fatigue （82.5%），dyspnea （81.1%），dry mouth （82.0%） and sleep disorders （78.8%）. Exploratory factor analysis revealed three symptom groups，namely somatic-sleep symptom cluster，fatigue-pain symptom cluster，and mood-related symptom cluster. Pre-pregnancy exercise and pre-gestational BMI were the influencing factors for the occurrence of somatic-sleep and fatigue-pain symptom clusters in advanced primipara in late pregnancy（adjusted R²=0.126，F=6.173，P<0.001；adjusted R²=0.156，F=5.140，P=0.006）. Educational background and monthly household income were the influencing factors for the occurrence of mood-related symptom cluster in advanced primipara in late pregnancy（adjusted R²=0.107，F=2.606，P=0.045）. Conclusion Advanced primiparas experience a variety of symptoms in late pregnancy and in the form of symptom clusters. Nursing staffs should develop targeted symptom management program based on the characteristics to ensure their safety and comfort.

Key words: Nursing, Advanced primipara, Gestation period, Symptom cluster