Schytt Erica, Waldenström Ulla
Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
J Womens Health (Larchmt). 2007 Apr;16(3):390-405. doi: 10.1089/jwh.2006.0030.
To investigate risk factors for poor self-rated health (SRH) in primiparous and multiparous women 2 months and 1 year after childbirth in a nationwide Swedish sample.
Women were recruited at their first booking visit at 593 (97%) antenatal clinics in Sweden during 3 weeks evenly spread over 1 year (1999-2000). Data were collected by questionnaires in early pregnancy, 2 months and 1 year after childbirth, and from the Medical Birth Register. In total, 2424 women filled in all the questionnaires, including a global question on SRH. The representativity of the sample was assessed by comparison with the total Swedish birth cohort of 1999. Data were analyzed by logistic regression analysis.
Physical problems, such as tiredness, musculoskeletal symptoms, and abdominal pain, and emotional problems, such as depressive symptoms, increased the risk of poor SRH in both primiparas and multiparas at one or both time points. Infant-related risk factors in both groups were negative experience of breastfeeding (2 months) and infant sleeping problems (1 year), and prematurity was a risk factor in primiparas at 2 months. Insufficient social support increased the risk in multiparas. In primiparas, outcome of labor, such as negative birth experience after operative delivery, was associated with poor SRH at 1 year and perineal pain at 2 months.
A new mother's SRH is associated with her life situation. Ongoing physical and emotional problems, lack of support, and infant factors seem more important than sociodemographic background. Mode of delivery and childbirth experience may have a longterm effect on SRH.
在瑞典全国性样本中，调查初产妇和经产妇产后2个月及1年时自我健康评价较差（SRH）的风险因素。
在瑞典593家（97%）产前诊所进行首次预约就诊时招募女性，时间分布在1年（1999 - 2000年）的3周内，每周均匀分布。通过问卷调查收集孕早期、产后2个月和1年的数据，并从医疗出生登记处获取信息。共有2424名女性填写了所有问卷，包括关于SRH的总体问题。通过与1999年瑞典出生队列总数进行比较来评估样本的代表性。采用逻辑回归分析进行数据分析。
身体问题，如疲劳、肌肉骨骼症状和腹痛，以及情绪问题，如抑郁症状，在一个或两个时间点均增加了初产妇和经产妇SRH较差的风险。两组中与婴儿相关的风险因素包括母乳喂养的负面经历（2个月时）和婴儿睡眠问题（1年时），早产是初产妇2个月时的一个风险因素。社会支持不足增加了经产妇的风险。在初产妇中，分娩结局，如手术分娩后的负面分娩经历，与1年时的SRH较差和2个月时的会阴疼痛有关。
新妈妈的SRH与其生活状况相关。持续存在的身体和情绪问题、缺乏支持以及婴儿因素似乎比社会人口统计学背景更为重要。分娩方式和分娩经历可能对SRH有长期影响。
