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产前创伤、压力、社会支持以及在美国居住年限对美国低收入拉丁裔产后产妇健康状况的影响。

The influence of prenatal trauma, stress, social support, and years of residency in the US on postpartum maternal health status among low-income Latinas.

机构信息

Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

出版信息

Matern Child Health J. 2011 Oct;15(7):1046-54. doi: 10.1007/s10995-010-0649-9.

Abstract

This study examined the associations of prenatal psychosocial factors, including depressive symptoms, post-traumatic stress disorder symptoms, trauma exposure including intimate partner violence, perceived stress, and social support, with perceived postpartum health status. Low-income Latinas (N = 203) were recruited from two health plans within the first 12 weeks of their pregnancies and followed through 3 months after birth. Participants completed semi-structured interviews conducted in English or Spanish within the first 12 weeks of pregnancy, and again at 12 weeks postpartum. Perceived health status was measured by the SF-12. Participants with complete follow-up data (n= 193) were used in data analysis. Women were mostly foreign-born (75%) with low-incomes (59%) and reported postpartum health status in the average range (M = 102.5; SD = 12.2). Overall health status was positively associated with decreased levels of perceived stress (P < .0001), being foreign-born and having resided in the US <10 years (P = .003). Emotional well-being was positively linked with being foreign-born and having resided in the US <10 years (P = .002), increased levels of social support (P = .01), and decreased levels of perceived stress (P < .001). Exposure to non-specific IPV trauma (P = .01) and health problems experienced during pregnancy or delivery (P = .05) were negatively associated with physical health status. Prenatal psychosocial factors and length of residency in the US are differentially predictive of overall postpartum health status and emotional well-being, and have less impact on physical well-being after birth. Health professionals are encouraged to assess these factors in early pregnancy.

摘要

本研究探讨了产前心理社会因素与产后健康状况感知之间的关联,这些因素包括抑郁症状、创伤后应激障碍症状、创伤暴露(包括亲密伴侣暴力)、感知压力和社会支持。研究招募了来自两个健康计划的 203 名低收入拉丁裔妇女,在她们怀孕的前 12 周内进行招募,并在产后 3 个月进行随访。参与者在怀孕的前 12 周内完成了英语或西班牙语的半结构式访谈,然后在产后 12 周再次进行访谈。采用 SF-12 量表评估产后健康状况。使用具有完整随访数据的参与者(n=193)进行数据分析。参与者大多为外国出生(75%),收入较低(59%),报告的产后健康状况处于平均水平(M=102.5;SD=12.2)。整体健康状况与感知压力水平降低呈正相关(P<0.0001),外国出生且在美国居住时间<10 年与感知压力水平降低呈正相关(P=0.003)。情感健康与外国出生和在美国居住时间<10 年(P=0.002)、社会支持水平增加(P=0.01)和感知压力水平降低(P<0.001)呈正相关。非特定性亲密伴侣暴力暴露(P=0.01)和怀孕期间或分娩期间出现的健康问题(P=0.05)与身体健康状况呈负相关。产前心理社会因素和在美国居住的时间长短对整体产后健康状况和情感健康有不同的预测作用,对产后身体健康状况的影响较小。鼓励医疗保健专业人员在孕早期评估这些因素。

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