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孕期的社会支持:对母亲抑郁症状、吸烟及妊娠结局的影响

Social support during pregnancy: effects on maternal depressive symptoms, smoking and pregnancy outcome.

作者信息

Elsenbruch S, Benson S, Rücke M, Rose M, Dudenhausen J, Pincus-Knackstedt M K, Klapp B F, Arck P C

机构信息

Department of Medical Psychology, University Clinic of Essen, University of Duisburg-Essen, Essen, Germany.

出版信息

Hum Reprod. 2007 Mar;22(3):869-77. doi: 10.1093/humrep/del432. Epub 2006 Nov 16.

Abstract

BACKGROUND

The goal was to study the effects of social support during pregnancy on maternal depressive symptoms, quality of life and pregnancy outcomes.

METHODS

Eight hundred ninety-six women were prospectively studied in the first trimester of pregnancy and following completion of the pregnancy. The sample was divided into quartiles yielding groups of low, medium and high social support based on perceived social support.

RESULTS

Pregnant women with low support reported increased depressive symptoms and reduced quality of life. The effects of social support on pregnancy outcomes were particularly pronounced in women who had smoked during pregnancy, with significant main effects of social support in a two-way analysis of variance (smoking status and social support) for child body length (F = 4.26, P = 0.04; 50.43 +/- 2.81 cm with low support versus 51.76 +/- 2.31 cm with high support) and birthweight (F = 11.35, P = 0.001; 3175 +/- 453 g with low support versus 3571 +/- 409 g with high support). In smokers, pregnancy complications occurred more frequently when given low support {34 versus 10.3% with high support, chi(2) = 5.49, P = 0.019; relative risk (RR) = 3.3 [95% confidence interval (95% CI) = 1.1-10.2]}, and the proportion of preterm deliveries was greater given low support (10.0 versus 0% with high support, chi(2) = 3.84, P = 0.05, odds ratio = 8.1).

CONCLUSIONS

Lack of social support constitutes an important risk factor for maternal well-being during pregnancy and has adverse effects on pregnancy outcomes.

摘要

背景

本研究旨在探讨孕期社会支持对孕妇抑郁症状、生活质量及妊娠结局的影响。

方法

对896名孕妇进行前瞻性研究,从妊娠早期开始直至妊娠结束。根据感知到的社会支持程度,将样本分为四分位数,形成低、中、高社会支持组。

结果

社会支持低的孕妇抑郁症状增加,生活质量下降。社会支持对妊娠结局的影响在孕期吸烟的女性中尤为明显,在双因素方差分析(吸烟状况和社会支持)中,社会支持对胎儿身长(F = 4.26,P = 0.04;低支持组为50.43±2.81厘米,高支持组为51.76±2.31厘米)和出生体重(F = 11.35,P = 0.001;低支持组为3175±453克,高支持组为3571±409克)有显著的主效应。在吸烟者中,社会支持低时妊娠并发症更频繁发生{34%对高支持组的10.3%,χ² = 5.49,P = 0.019;相对危险度(RR)= 3.3 [95%置信区间(95%CI)= 1.1 - 10.2]},低支持组早产比例更高(10.0%对高支持组的0%,χ² = 3.84,P = 0.05,比值比 = 8.1)。

结论

缺乏社会支持是孕期孕产妇健康的重要危险因素,对妊娠结局有不良影响。

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