复发性流产（Recurrent Spontaneous Abortion，RSA）是妊娠28周前自然终止的现象，影响1%-5%的育龄女性。RSA患者不仅经历了生理上的伤害，还遭受着由家庭、社会压力导致的心理伤害，进而出现抑郁、焦虑等消极情绪，以及生活满意度的降低。近年来，正念的概念和实践在缓解这些负面情绪中显示了潜在的效用，特别是特质正念——个体在日常生活中自然而然地维持正念状态的能力——被认为对提高生活质量具有长期影响。研究指出，正念能够通过多种机制有效地调节情绪，减少焦虑和抑郁情绪的发生。情绪调节能力是个体对自身情绪进行监测、评估和调整的过程，直接关联个人的社会适应性和心理健康。在RSA患者中，情绪调节困难可能导致妊娠期的压力增加，加剧焦虑、抑郁症状，不仅对孕妇自身的健康产生负面影响，还可能通过内分泌和免疫系统的变化影响胎儿，增加不良妊娠结局的风险，降低生活满意度。

目的：（1）探究RSA患者情绪调节、妊娠压力、心理健康状况（包括抑郁、焦虑和生活满意度）的水平；（2）研究正念对该群体心理状况的影响，高正念特质是否一种保护性因素；（3）探究正念改善该群体心理健康状况中的作用机制。

方法：采用横断面研究设计，通过方便抽样方法于2023年9月至2023年12月在兰州大学第二医院生殖医学科招募，纳入320例年满18岁且既往至少发生过2次妊娠28周之前的胚胎或胎儿丢失的RSA患者。通过《正念觉知注意量表》《广泛性焦虑量表》《抑郁症筛查量表》《生活满意度量表》《情绪调节困难量表》及《妊娠压力量表》对患者的特质正念、焦虑、抑郁、情绪调节困难、产次数对特质正念、焦虑、抑郁和生活满意度的影响。本研究通过SPSS工具对研究数据进行了分析，包括Mann-Whitney U检验、t检验、Fisher精确概率检验、卡方检验、以及多元层次回归分析。

结论：（1）本研究证实，在RSA患者中，特质正念与焦虑、抑郁和生活满意度显著相关；（2）本研究揭示了在RSA患者中，情绪调节困难和妊娠压力在特质正念与焦虑、抑郁和生活满意度之间起链式中介效应；（3）本研究的发现为制定针对RSA患者的心理健康干预措施提供了科学依据。特别是通过培养正念和改善情绪调节技能，以及为患者提供关于如何应对妊娠压力的指导，可能对提升患者的心理健康和生活质量具有积极影响。

Recurrent spontaneous abortion (RSA), the natural termination of pregnancy before 28 weeks, affects 1%-5% of women of childbearing age. RSA patients not only suffer physiological damage but also undergo psychological distress arising from familial and societal pressures, leading to depression, anxiety, and decreased life satisfaction. In recent years, mindfulness has shown promising potential in alleviating these negative emotional states. Particularly, trait mindfulness, a natural ability to maintain a mindful state in daily life, is believed to have long-term effects on improving quality of life. Research indicates that mindfulness can effectively regulate emotions through various mechanisms, reducing the occurrence of anxiety and depression. Emotion regulation refers to the process of monitoring, evaluating, and adjusting one's own emotions, which is directly associated with personal and social adaptability as well as psychological well-being. In patients with RSA, difficulties in emotional regulation may lead to exacerbated stress, anxiety, and depressive symptoms. These factors may not only negatively affect the health of the pregnant woman, but also have an impact on the fetus through changes in the endocrine and immune systems. This increases the risk of adverse pregnancy outcomes and reduces life satisfaction.

Objectives: (1) To explore the differences in emotional regulation, pregnancy stress and mental health status (including depression, anxiety and life satisfaction) between RSA patients and normal pregnant women. (2) To study the effect of mindfulness on the psychological status of this group and whether a high mindfulness trait is a protective factor for RSA patients. (3) To explore the mechanism of mindfulness in improving the mental health status of this group.

Methods: Utilizing a cross-sectional study design, a convenient sampling method was employed to recruit 320 participants from the Reproductive Medicine Department of Lanzhou University Second Hospital between September 2023 and December 2023. Participants were eligible if they were aged 18 years or older and had experienced two or more embryo or fetal loss before 28 weeks of gestation. Assessment of participants' trait mindfulness, anxiety, depression, emotion regulation difficulties, pregnancy stress, and life satisfaction levels was conducted using standardized instruments including the Mindful Attention Awareness Scale, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, The Satisfaction with Life Scale, Difficulties in Emotion Regulation Scale-18, and Prenatal Maternal Stress. We also explored the effects of the number of live births and miscarriages on trait mindfulness, anxiety, depression, and life satisfaction at different pregnancy stages. Statistical analysis was performed using SPSS software, including the Mann-Whitney U test, t-test, Fisher exact probability test, Chi-square test, and multiple hierarchical regression analysis.

Conclusions: (1) This study confirmed a significant correlation between trait mindfulness, anxiety/depression symptoms, and life satisfaction among RSA patients. (2) This study revealed a chain mediation effect of emotion regulation difficulties and pregnancy stress on the relationship between trait mindfulness and anxiety/depression symptoms and life satisfaction among RSA patients. (3) Findings from this study provide scientific evidence for developing psychological interventions tailored to RSA patients. Particularly, fostering mindfulness, improving emotion regulation skills, and providing guidance on coping with pregnancy stress may positively impact the psychological health and quality of life of RSA patients.