Article(id=1324078082994340011, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078037817504735, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508185, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1755014400000, receivedDateStr=2025-08-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614415167, onlineDateStr=2026-11-02, pubDate=1770652800000, pubDateStr=2026-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614415167, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614415167, creator=13701087609, updateTime=1793614415167, updator=13701087609, issue=Issue{id=1324078037817504735, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='1770652800000', pubDateStr='2026-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614404396, creator='13701087609', updateTime=1793614474144, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078330420527919, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078037817504735, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078330420527920, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078037817504735, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=466, endPage=470, ext={EN=ArticleExt(id=1324078083191472300, articleId=1324078082994340011, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association of nighttime social media use, sleep duration, and executive function decline during pregnancy: isotemporal substitution model, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the association between nighttime social media use, sleep duration, and executive function decline in pregnant women, as well as the isotemporal substitution effect.

Methods

Pregnant women attending the obstetric outpatient department of Qilu Hospital in Jinan, Shandong Province were recruited using the convenience sampling method for a questionnaire survey. Single-factor, partition and isotemporal substitution models were used to analyze the relationship between nighttime social media use, sleep duration, and executive function decline in pregnant women.

Results

A total of 628 pregnant women were included in the study. After adjusting for confounding factors, both the single model and the partition model indicated that nighttime social media use duration was significantly positively correlated with scores in total executive function decline (β=0.980; β=0.965), memory (β=0.595; β=0.585), and inhibitory control dimension (β=0.385; β=0.379) (all P<0.01). In contrast, sleep duration was significantly negatively correlated with scores in total executive function decline (β=-0.414; β=-0.402), memory (β=-0.255; β=-0.248), and inhibitory control dimension (β=-0.159; β=-0.154) (all P<0.05). The isotemporal substitution model showed that increasing sleep by 30 minutes to replace an equivalent amount of nighttime social media use was associated with a decrease in the total score of executive function decline among pregnant women (β=-2.047, P<0.001). The improvement in the memory dimension (β=-1.261, P<0.001) was greater than that in the inhibitory control dimension (β=-0.786, P<0.001).

Conclusion

Replacing 30 minutes of nighttime social media use with sleep is associated with reduced executive function decline in pregnant women. It is recommended that sleep management and digital behavior adjustment be incorporated into clinical interventions and health education to promote cognitive health in pregnant women and improve maternal and neonatal outcomes.

, authors=Meng-yao QIN1, Jing ZHAO2, Lei SHENG1, Feng-yi REN1, Xin LIU1, Xiao-yan LIU2, Xin-xia CHEN1, authorsList=Meng-yao QIN, Jing ZHAO, Lei SHENG, Feng-yi REN, Xin LIU, Xiao-yan LIU, Xin-xia CHEN, authorCompany=null, correspAuthors=Xin-xia CHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078084080664755, articleId=1324078082994340011, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=基于等时替代模型探讨夜间社交媒体使用、睡眠时长与孕期执行功能下降的关系, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

探讨夜间社交媒体使用和睡眠时长与孕妇执行功能下降的关联及等时替代效应。

方法

采用方便抽样法抽取山东省济南市齐鲁医院产科门诊的孕妇进行问卷调查,分别使用单因素模型、分割模型和等时替代模型分析孕妇夜间社交媒体使用、睡眠时长与执行功能下降的关系。

结果

共纳入628名孕妇。调整混杂因素后,单因素模型和分割模型均显示夜间社交媒体使用时长与执行功能下降总分(β=0.980、0.965)、记忆(β=0.595、0.585)和抑制控制维度(β=0.385、0.379)得分呈正相关(P均<0.01),睡眠时长与执行功能下降总分(β=-0.414、-0.402)、记忆(β=-0.255、-0.248)和抑制控制维度(β=-0.159、-0.154)得分呈负相关(P均<0.05)。等时替代模型显示,增加30min睡眠替代等量的夜间社交媒体使用,孕妇执行功能下降总分降低(β=-2.047,P<0.001)、记忆维度(β=-1.261,P<0.001)的改善程度大于抑制控制维度(β=-0.786,P<0.001)。

结论

用30 min睡眠替代夜间社交媒体使用与孕期执行功能下降改善有关。建议临床干预和健康教育中重视睡眠管理与数字行为习惯的调整,以促进孕妇的认知功能,优化母婴健康结局。

, authors=秦梦瑶1, 赵静2, 盛蕾1, 任丰毅1, 刘欣1, 刘晓燕2, 陈新霞1, authorsList=秦梦瑶, 赵静, 盛蕾, 任丰毅, 刘欣, 刘晓燕, 陈新霞, authorCompany=null, correspAuthors=陈新霞, authorNote=

秦梦瑶(2001—),女,硕士在读,研究方向:女性生育健康

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陈新霞,E-mail:
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Descriptive analysis of executive function decline in pregnant women ()

, figureFileSmall=null, figureFileBig=null, tableContent=
分类执行功能下降总分记忆维度得分抑制控制维度得分
总体32.13±9.4921.11±6.2611.01±3.71
年龄(岁)<3532.63±9.5321.39±6.2111.24±3.78
≥3530.66±9.2720.32±6.3510.34±3.42
t值2.286*1.8732.290**
职业公务人员34.95±9.5722.85±6.2312.10±3.71
专业技术人员30.41±8.9620.13±6.0410.28±3.45
公司职员32.10±9.2321.01±6.0711.09±3.65
个体34.09±11.0422.27±7.2011.81±4.17
农民或其他32.14±9.7321.39±6.4810.76±3.83
F值3.321*3.717**2.719*
家庭经济状况比较宽松29.97±10.2119.99±6.699.98±3.91
略有盈余31.50±9.2920.68±6.1110.82±3.62
收支平衡33.17±9.0821.77±6.0111.40±3.59
入不敷出30.83±12.5419.55±8.4711.29±4.64
F值3.326*3.387*2.956*
), ArticleFig(id=1324078089105440999, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078082994340011, language=CN, label=表1, caption=

孕期女性执行功能下降的描述性分析()

, figureFileSmall=null, figureFileBig=null, tableContent=
分类执行功能下降总分记忆维度得分抑制控制维度得分
总体32.13±9.4921.11±6.2611.01±3.71
年龄(岁)<3532.63±9.5321.39±6.2111.24±3.78
≥3530.66±9.2720.32±6.3510.34±3.42
t值2.286*1.8732.290**
职业公务人员34.95±9.5722.85±6.2312.10±3.71
专业技术人员30.41±8.9620.13±6.0410.28±3.45
公司职员32.10±9.2321.01±6.0711.09±3.65
个体34.09±11.0422.27±7.2011.81±4.17
农民或其他32.14±9.7321.39±6.4810.76±3.83
F值3.321*3.717**2.719*
家庭经济状况比较宽松29.97±10.2119.99±6.699.98±3.91
略有盈余31.50±9.2920.68±6.1110.82±3.62
收支平衡33.17±9.0821.77±6.0111.40±3.59
入不敷出30.83±12.5419.55±8.4711.29±4.64
F值3.326*3.387*2.956*
), ArticleFig(id=1324078089193521384, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078082994340011, language=EN, label=Table 2, caption=

Relationship between nighttime social media use, sleep duration, and executive function decline in pregnant women

, figureFileSmall=null, figureFileBig=null, tableContent=
模型夜间社交媒体使用时长夜间睡眠时长
β值(95%CI)P值β值(95%CI)P值
执行功能下降总分
单因素模型0.980(0.452~1.508)<0.001-0.414(-0.708~-0.120)0.006
分割模型0.965(0.439~1.490)<0.001-0.402(-0.694~-0.111)0.007
记忆维度
单因素模型0.595(0.245~0.945)0.001-0.255(-0.450~-0.060)0.010
分割模型0.585(0.237~0.934)0.001-0.248(-0.441~-0.055)0.012
抑制控制维度
单因素模型0.385(0.180~0.591)<0.001-0.159(-0.273~-0.044)0.007
分割模型0.379(0.175~0.584)<0.001-0.154(-0.268~-0.041)0.008
), ArticleFig(id=1324078089289990377, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078082994340011, language=CN, label=表2, caption=

夜间社交媒体使用、睡眠时长与孕期女性执行功能下降的关系

, figureFileSmall=null, figureFileBig=null, tableContent=
模型夜间社交媒体使用时长夜间睡眠时长
β值(95%CI)P值β值(95%CI)P值
执行功能下降总分
单因素模型0.980(0.452~1.508)<0.001-0.414(-0.708~-0.120)0.006
分割模型0.965(0.439~1.490)<0.001-0.402(-0.694~-0.111)0.007
记忆维度
单因素模型0.595(0.245~0.945)0.001-0.255(-0.450~-0.060)0.010
分割模型0.585(0.237~0.934)0.001-0.248(-0.441~-0.055)0.012
抑制控制维度
单因素模型0.385(0.180~0.591)<0.001-0.159(-0.273~-0.044)0.007
分割模型0.379(0.175~0.584)<0.001-0.154(-0.268~-0.041)0.008
), ArticleFig(id=1324078089390653674, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078082994340011, language=EN, label=Table 3, caption=

Effects of replacing 30 minutes of nighttime social media use with sleep on executive function decline in pregnant women

, figureFileSmall=null, figureFileBig=null, tableContent=
变量睡眠时长(替代夜间社交媒体使用)
β值(95%CI)P值
执行功能下降总分-2.047(-2.619~-1.476)<0.001
记忆维度-1.261(-1.642~-0.880)<0.001
抑制控制维度-0.786(-1.010~-0.564)<0.001
), ArticleFig(id=1324078091076763883, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078082994340011, language=CN, label=表3, caption=

30 min睡眠替代夜间社交媒体使用对孕期女性执行功能下降的影响

, figureFileSmall=null, figureFileBig=null, tableContent=
变量睡眠时长(替代夜间社交媒体使用)
β值(95%CI)P值
执行功能下降总分-2.047(-2.619~-1.476)<0.001
记忆维度-1.261(-1.642~-0.880)<0.001
抑制控制维度-0.786(-1.010~-0.564)<0.001
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基于等时替代模型探讨夜间社交媒体使用、睡眠时长与孕期执行功能下降的关系
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秦梦瑶 1 , 赵静 2 , 盛蕾 1 , 任丰毅 1 , 刘欣 1 , 刘晓燕 2 , 陈新霞 1
现代预防医学 | 儿少卫生与妇幼保健 2026,53(3): 466-470
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (3) : 466 -470
基于等时替代模型探讨夜间社交媒体使用、睡眠时长与孕期执行功能下降的关系
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秦梦瑶1, 赵静2, 盛蕾1, 任丰毅1, 刘欣1, 刘晓燕2, 陈新霞1
作者信息
  • 1.山东大学护理与康复学院,山东 济南 250012
  • 2.山东大学齐鲁医院产科
通讯作者:
陈新霞,E-mail:
作者简介:

秦梦瑶(2001—),女,硕士在读,研究方向:女性生育健康

Association of nighttime social media use, sleep duration, and executive function decline during pregnancy: isotemporal substitution model
Meng-yao QIN1, Jing ZHAO2, Lei SHENG1, Feng-yi REN1, Xin LIU1, Xiao-yan LIU2, Xin-xia CHEN1
Affiliations
  • School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong 250012, China
出版时间: 2026-02-10 doi: 10.20043/j.cnki.MPM.202508185
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目的

探讨夜间社交媒体使用和睡眠时长与孕妇执行功能下降的关联及等时替代效应。

方法

采用方便抽样法抽取山东省济南市齐鲁医院产科门诊的孕妇进行问卷调查,分别使用单因素模型、分割模型和等时替代模型分析孕妇夜间社交媒体使用、睡眠时长与执行功能下降的关系。

结果

共纳入628名孕妇。调整混杂因素后,单因素模型和分割模型均显示夜间社交媒体使用时长与执行功能下降总分(β=0.980、0.965)、记忆(β=0.595、0.585)和抑制控制维度(β=0.385、0.379)得分呈正相关(P均<0.01),睡眠时长与执行功能下降总分(β=-0.414、-0.402)、记忆(β=-0.255、-0.248)和抑制控制维度(β=-0.159、-0.154)得分呈负相关(P均<0.05)。等时替代模型显示,增加30min睡眠替代等量的夜间社交媒体使用,孕妇执行功能下降总分降低(β=-2.047,P<0.001)、记忆维度(β=-1.261,P<0.001)的改善程度大于抑制控制维度(β=-0.786,P<0.001)。

结论

用30 min睡眠替代夜间社交媒体使用与孕期执行功能下降改善有关。建议临床干预和健康教育中重视睡眠管理与数字行为习惯的调整,以促进孕妇的认知功能,优化母婴健康结局。

孕妇  /  社交媒体  /  夜间  /  睡眠  /  执行功能下降
Objective

To explore the association between nighttime social media use, sleep duration, and executive function decline in pregnant women, as well as the isotemporal substitution effect.

Methods

Pregnant women attending the obstetric outpatient department of Qilu Hospital in Jinan, Shandong Province were recruited using the convenience sampling method for a questionnaire survey. Single-factor, partition and isotemporal substitution models were used to analyze the relationship between nighttime social media use, sleep duration, and executive function decline in pregnant women.

Results

A total of 628 pregnant women were included in the study. After adjusting for confounding factors, both the single model and the partition model indicated that nighttime social media use duration was significantly positively correlated with scores in total executive function decline (β=0.980; β=0.965), memory (β=0.595; β=0.585), and inhibitory control dimension (β=0.385; β=0.379) (all P<0.01). In contrast, sleep duration was significantly negatively correlated with scores in total executive function decline (β=-0.414; β=-0.402), memory (β=-0.255; β=-0.248), and inhibitory control dimension (β=-0.159; β=-0.154) (all P<0.05). The isotemporal substitution model showed that increasing sleep by 30 minutes to replace an equivalent amount of nighttime social media use was associated with a decrease in the total score of executive function decline among pregnant women (β=-2.047, P<0.001). The improvement in the memory dimension (β=-1.261, P<0.001) was greater than that in the inhibitory control dimension (β=-0.786, P<0.001).

Conclusion

Replacing 30 minutes of nighttime social media use with sleep is associated with reduced executive function decline in pregnant women. It is recommended that sleep management and digital behavior adjustment be incorporated into clinical interventions and health education to promote cognitive health in pregnant women and improve maternal and neonatal outcomes.

Pregnant women  /  Social media use  /  Nighttime  /  Sleep  /  Executive function decline
秦梦瑶, 赵静, 盛蕾, 任丰毅, 刘欣, 刘晓燕, 陈新霞. 基于等时替代模型探讨夜间社交媒体使用、睡眠时长与孕期执行功能下降的关系. 现代预防医学, 2026 , 53 (3) : 466 -470 . DOI: 10.20043/j.cnki.MPM.202508185
Meng-yao QIN, Jing ZHAO, Lei SHENG, Feng-yi REN, Xin LIU, Xiao-yan LIU, Xin-xia CHEN. Association of nighttime social media use, sleep duration, and executive function decline during pregnancy: isotemporal substitution model[J]. Modern Preventive Medicine, 2026 , 53 (3) : 466 -470 . DOI: 10.20043/j.cnki.MPM.202508185
执行功能(executive functioning)是大脑的高级认知控制能力,主要包括工作记忆、抑制控制和认知灵活性[1],它通过调控个体的思想与行动以维持目标导向行为[2]。孕期执行功能易受影响,许多孕妇报告出现“婴儿脑”,表现为记忆力下降[3-4]或注意力分散、情绪改变等抑制控制能力下降[4-5]。对于孕妇而言,执行功能下降直接关系到孕期健康管理的质量,孕期认知状态变化会影响其坚持健康饮食、规律产检的能力,增加非健康生活方式选择的倾向性,并诱发焦虑、抑郁等情绪问题,危害母婴健康[6]。因此,明确孕期执行功能下降的可干预性影响因素,对优化母婴健康结局具有重要意义。
近年来,随着社交媒体的普及,社交媒体使用和睡眠已被视为执行功能下降的重要影响因素。目前,使用社交媒体已经成为多数人日常生活的常规行为,尤其在夜间睡前非常普遍[7]。在学龄期儿童和成年人的研究显示,过度使用社交媒体与执行功能下降存在正向关联[8-9],长时间大量使用社交媒体会导致记忆力下降[10-11]、冲动控制较差和注意力不集中[12-14]。值得注意的是,夜间过度使用社交媒体会进一步加剧这种影响,因为屏幕蓝光和持续的心理刺激会直接干扰睡眠节律[15-16]。睡眠与执行功能下降存在密切关联,最近的一项研究发现,睡眠质量差可能导致孕妇出现认知障碍[17]。然而,夜间社交媒体使用和睡眠时长与孕妇执行功能下降的关联尚未见报道。并且,夜间社交媒体使用与睡眠可能相互影响,长时间使用社交媒体会缩短睡眠时长并导致入睡困难[18],睡眠延迟又会进一步增加社交媒体的使用时间[19],两类行为的时间分配存在固有约束。现有研究主要探讨了两者对执行功能下降的单独影响,忽略了行为之间的相互作用。等时替代模型为解决这一问题提供了方法学支持,该模型的核心思想是:基于个体总时间恒定的前提,以某类活动等量替代另一类活动的时间,分析此类 “替代” 对特定健康结局的预期影响[20]。综上,本研究拟探讨孕妇夜间社交媒体使用和睡眠时长与执行功能下降的关联,并分析睡眠替代等量的夜间社交媒体使用对执行功能下降的影响,为改善孕期健康提供依据。
采用便利抽样于2024年11月—2025年6月在山东省济南市齐鲁医院产科门诊招募研究对象,纳入标准:已婚;年龄≥20岁;处于妊娠期;知情同意且自愿参与调查;能够独立使用智能手机;至少使用一种社交媒体平台;无严重躯体疾病和精神系统疾病。发放650份,剔除缺失样本后,最终纳入有效问卷628份。本研究已通过山东大学护理与康复学院伦理委员会批准(2024-R-135)。
包括年龄、孕前身体质量指数(body mass index,BMI)、职业、家庭经济状况、文化程度。
夜间社交媒体使用时长通过Heather等人[21]编制,熊智强[22]汉化的夜间社交媒体使用量表的最后一个条目进行测量。具体条目为:“上床之后您使用社交媒体的时间是?”,选项为五个时间区间,采用区间中点赋值法进行数据转换。
睡眠时长用匹兹堡睡眠问卷[23]的前两个问题进行收集,包括“在工作日(周一至周五),您通常在几点入睡,几点醒来?在自由日(周六日或节假日),您通常在几点入睡,几点醒来?”。每日睡眠时长=(工作日睡眠时长×5+自由日睡眠时长×2)/7。
孕妇的执行功能下降采用由Holst等人[2]编制的成人版执行功能量表中文版[24]进行测试。量表共14个条目,采用5点计分,包括工作记忆和抑制控制两个维度,前者是指与其他认知功能协调保存和操作信息的能力,后者是指监控和调节适应性行为的能力,得分越高代表执行功能越差。原量表的信效度良好,本研究中Cronbach α系数为0.915。
采用SPSS 26.0进行统计学分析,对符合正态分布的数据采用()进行描述,采用t检验和方差分析比较组间差异。基于多重线性回归进行等时替代分析,具体包括单一活动模型、分割模型和等时替代模型三个子模型,以探讨夜间社交媒体使用时长、睡眠时长与孕妇执行功能下降之间的关联。本研究样本量为自变量数量20倍以上[25],方差膨胀因子均小于10,满足等时替代模型应用条件。借鉴国内研究证实的30 min替代效应可行性[26-27],将所有活动原始时长除以30得标准化单位,1单位代表实际时长增加30 min。为控制总活动时间恒定,本研究将夜间社交媒体使用时长与睡眠时长相加,定义并固定为总活动时长纳入回归模型。
单一活动模型分析每个活动行为与孕妇执行功能下降的独立关联,以夜间社交媒体使用时长为例,孕妇执行功能下降=β1×夜间社交媒体使用时长+β4×协变量。分割模型同时纳入关注的两种活动行为,将夜间总活动时间拆分为夜间社交媒体使用时长、睡眠时长作为独立行为变量并同时纳入模型,考察每种独立行为与孕妇执行功能下降的关联,孕妇执行功能下降=β1×夜间社交媒体使用时长+β2×睡眠时长+β4×协变量。等时替代模型则将夜间总活动行为时长纳入模型,分析用30 min的睡眠替代夜间社交媒体使用后执行功能下降的变化,孕妇的执行功能下降=β2×睡眠时长+β3×总活动时长+β4×协变量。β2表示保持总活动时长不变的情况下,用30 min的睡眠替代夜间社交媒体使用后孕妇执行功能下降的变化量。其中,β1~β4为各自活动或协变量的系数。上述模型均调整协变量。双侧检验,检验水准α=0.05。
共纳入628名孕妇,年龄(31.49±4.09)岁;公务人员60例(9.55%),专业技术人员160例(25.48%),公司职员295例(46.97%),个体59例(9.40%),农民或其他54例(8.60%)。家庭经济状况比较宽松91例(14.49%),略有盈余187例(29.78%),收支平衡329例(52.39%),入不敷出21例(3.34%)。所有调查对象均在每天夜间使用社交媒体。夜间社交媒体使用时长(54.34±42.11)min/d、睡眠时长(468.76±71.51)min/d。不同年龄、职业、家庭经济状况孕妇执行功能下降总分差异均有统计学意义(P值均<0.05)。见表1。
单因素模型结果显示,控制年龄、孕前BMI、职业、家庭经济状况、文化程度协变量后,夜间社交媒体使用时长与孕妇执行功能下降总分呈正相关(β=0.980, 95% CI: 0.452~1.508, P<0.001),睡眠时长与执行功能下降总分呈负相关(β=-0.414, 95% CI:-0.708~-0.120, P=0.006)。
将夜间社交媒体使用和睡眠时长同时纳入分析,分割模型的结果与单一因素模型相似。每增加30 min的夜间社交媒体使用,可使孕妇执行功能下降总分增加0.965(β=0.965, 95% CI: -0.439~1.490, P<0.001),表明执行功能减退。分层分析显示,记忆维度(β=0.585, 95% CI: 0.237~0.934, P=0.001)较抑制控制维度(β=0.379, 95% CI: 0.175~0.584, P<0.001)下降程度更大。相反,每增加30min睡眠,可使孕妇执行功能下降总分降低0.402(β=-0.402, 95% CI:-0.694~-0.111, P=0.007),表明延长夜间睡眠有助于改善执行功能,其中记忆维度相比抑制控制维度改善更为明显。见表2。
等时替代模型结果发现,以30 min睡眠替代等量夜间社交媒体使用后,孕妇的执行功能下降改善(β=-2.047, 95% CI: -2.619~-1.476, P<0.001)。分维度分析结果显示,睡眠的替代作用对记忆功能(β=-1.261, 95% CI: -1.642~-0.880, P<0.001)改善程度大于抑制控制功能(β=-0.786, 95% CI: -1.010~-0.564, P<0.001)。见表3。
本研究突破了传统研究孤立分析的局限,采用单因素模型、分割模型和等时替代模型三种分析方法,不但揭示了夜间社交媒体使用和睡眠时长与孕妇执行功能下降的关系,且进一步明确了睡眠替代等量的夜间社交媒体使用对改善执行功能下降的预期影响。
本研究发现,夜间社交媒体时长与孕妇执行功能下降存在正向关系,表明夜间社交媒体使用时间越长,孕妇的执行功能越差,与前人在466名普通成年群体[10](β=-0.22, P<0.05)及782名25~75岁中年群体[11]中有关社交媒体使用对记忆功能的研究结果类似。高秋峰[14]在2 000名大学生群体和杨旭[13]在66名参与者的研究中为社交媒体使用对抑制控制的影响提供了电生理学证据,二者均通过Go-Nogo任务发现,过度使用社交媒体的用户在任务中存在后期抑制控制过程困难的特征。夜间社交媒体使用影响孕妇执行功能下降的潜在机制可从多方面解释。第一,社交媒体允许人们以照片、帖子等形式记录并分享日常体验,而这种记录与分享行为可能降低个体对经历的详细记忆[28];第二,社交媒体使用通过诱导多任务处理,中断连续的认知加工过程,削弱抑制控制功能[29];第三,夜间使用社交媒体还可能通过扰乱睡眠节律、缩短有效睡眠时间等途径[15-16],间接对执行功能产生负面影响。此外,Anna等人[30]报道,长时间使用社交媒体会导致大脑活动发生改变,前额叶皮层活动减少,进而导致工作记忆受损和反应抑制。
睡眠是影响执行功能下降的重要因素。既往研究显示怀孕期间睡眠质量较低与认知功能较差有关[17,31],本研究进一步揭示了睡眠时长与孕妇执行功能下降的负向关联,与胥等[32]在209名3~6岁学龄前儿童中的研究结果一致,该研究发现,学龄前儿童的睡眠时间占比与其执行功能改善呈正相关(β=15.30,P<0.001)。对于孕妇而言,睡眠障碍影响了高达62%的孕妇[33],特殊的生理变化本身已对认知状态构成威胁,而保证充足的睡眠能有效缓冲这一不利影响。
本研究进一步采用等时替代模型,探究了睡眠替代等量的夜间社交媒体使用对执行功能下降的预期影响。结果发现30 min的睡眠替代等量的夜间社交媒体使用,孕妇执行功能下降总分和各维度得分变化均具有显著性差异,且对于记忆维度的改善程度更大。从睡眠的神经生理机制来看[34]:快速眼动睡眠与情绪调节和记忆整合密切相关,非快速眼动睡眠在记忆巩固和前额叶皮层的功能恢复中起关键作用,前额叶皮层的神经活动效率是抑制控制的核心神经基础。而夜间社交媒体使用往往伴随蓝光暴露、信息接收的持续性刺激[15],延长入睡潜伏期、缩短深度睡眠时长,间接削弱记忆巩固和抑制控制功能的生理基础。当以30 min睡眠替代这部分社交媒体使用时,相当于为孕妇补充了更完整的睡眠周期,使大脑在记忆提取、信息处理时更高效。其次,电生理水平的研究发现,恢复睡眠可以逆转睡眠受限引起的反应抑制受损[35]。因此,充足的睡眠对增强孕妇的记忆和抑制控制能力至关重要,将夜晚的社交媒体使用时间向睡眠转化是改善孕妇执行功能下降可行的有效途径。
本研究基于等时替代分析,首次探讨了夜间社交媒体使用和睡眠时长与孕妇执行功能下降的关系,揭示了睡眠替代等量的夜间社交媒体使用对改善执行功能下降的预期影响。结果表明,夜间社交媒体使用与睡眠时长是影响孕期执行功能下降的重要因素,强调了优化时间分配作为孕期行为干预靶点的重要性。然而,本研究还存在部分局限性:研究只在一座城市的一家医院收集,主观报告的测量方法存在回忆偏倚,横断面的研究设计限制了因果关系的确定,未来研究可进一步采用客观测量手段,在大样本、多中心的纵向研究中验证本研究结论,增强结果的稳健性与推广性。此外,本研究主要聚焦夜间社交媒体的使用时长,未来的研究可以采用更综合的指标(如频率),以更全面地揭示不同使用模式与认知健康的关系。
综上所述,在孕妇群体中,每天30 min的睡眠等时替代夜间社交媒体使用和孕妇执行功能下降改善存在关联。在等量的时间下,对孕妇记忆功能的的改善程度大于抑制控制功能。这为临床开展孕期认知健康管理提供了简单可行的干预思路,有助于医护人员指导孕妇通过调整睡前时间分配,降低因执行功能下降可能带来的母婴健康风险。
  • 山东省自然科学基金(ZR2025MS1448)
  • 山东大学齐鲁医学特色本科教育教学研究项目(qlyxjy-202342)
  • 山东大学本科教育教学改革研究项目(2023Y086)
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2026年第53卷第3期
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doi: 10.20043/j.cnki.MPM.202508185
  • 接收时间:2025-08-13
  • 首发时间:2026-11-02
  • 出版时间:2026-02-10
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  • 收稿日期:2025-08-13
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山东省自然科学基金(ZR2025MS1448)
山东大学齐鲁医学特色本科教育教学研究项目(qlyxjy-202342)
山东大学本科教育教学改革研究项目(2023Y086)
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    1.山东大学护理与康复学院,山东 济南 250012
    2.山东大学齐鲁医院产科

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
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