Kavanaugh Megan, McMillen Robert C, Pascoe John M, Hill Southward Linda, Winickoff Jonathan P, Weitzman Michael
American Academy of Pediatrics, Rochester, NY 14620, USA.
Ambul Pediatr. 2005 Nov-Dec;5(6):341-8. doi: 10.1367/A04-207R.1.
Both maternal smoking and depression are common and can adversely impact child health and functioning, yet few studies have explored their co-occurrence among mothers.
To determine the prevalence and associations of depression and smoking among mothers in the United States.
Random-digit-dial national telephone survey of 1530 households conducted in 2002. Respondents were asked about their sociodemographic characteristics, smoking status, and their children's receipt of Medicaid. A validated 3-item depression screen was administered. Bivariate and multiple regression analyses for maternal smoking and a positive depression screen were performed.
National sample.
Seven hundred two mothers with children aged less than 19 years living in their homes.
The response rate was 61%. Among mothers, 24.3% were smokers, 24.4% had a positive depression screen, 8.1% had both, and 40.6% were smokers and/or had a positive depression screen. All rates were greater among mothers whose children receive Medicaid (37.6%, 47.5%, 20.6%, and 64.5%) than those whose children do not receive Medicaid (21.1%, 19.0%, 4.8%, and 35.3%) (P < .001) for each. In multivariate analyses, maternal smoking was independently associated with a 70% increased risk of depressive symptoms (odds radio, 1.7; 95% confidence interval, 1.1-2.6).
This study highlights both the frequency and the co-occurrence of maternal smoking and maternal depressive symptoms, two negative influences on children's health and development, as well as their increased prevalence among mothers whose children receive Medicaid, thereby highlighting the economic disparities associated with both. These findings have significant implications for our nation's children, health care clinicians, and health care payers.
母亲吸烟和患抑郁症的情况都很常见，且都会对儿童健康和机能产生不利影响，但很少有研究探讨二者在母亲群体中的共存情况。
确定美国母亲群体中抑郁症和吸烟的患病率及相关性。
2002年对1530户家庭进行的随机数字拨号全国电话调查。询问受访者的社会人口学特征、吸烟状况以及其子女是否接受医疗补助。采用经过验证的3项抑郁症筛查工具。对母亲吸烟情况和抑郁症筛查呈阳性进行双变量和多元回归分析。
全国样本。
702名家中有19岁以下子女的母亲。
应答率为61%。在母亲群体中，24.3%为吸烟者，24.4%抑郁症筛查呈阳性，8.1%两者兼具，40.6%为吸烟者和/或抑郁症筛查呈阳性。在子女接受医疗补助的母亲中，上述各项比例（分别为37.6%、47.5%、20.6%和64.5%）均高于子女未接受医疗补助的母亲（分别为21.1%、19.0%、4.8%和35.3%）（每项P < .001）。在多变量分析中，母亲吸烟与抑郁症状风险增加70%独立相关（比值比，1.7；95%置信区间，1.1 - 2.6）。
本研究凸显了母亲吸烟和母亲抑郁症状的发生频率及共存情况，这两者都是对儿童健康和发育的负面影响，同时也凸显了在子女接受医疗补助的母亲中二者患病率更高，从而凸显了与之相关的经济差距。这些发现对我国儿童、医疗保健临床医生和医疗保健支付方具有重大意义。
