Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Am J Prev Med. 2010 Oct;39(4):345-51. doi: 10.1016/j.amepre.2010.05.023.
The majority of women who quit smoking as a result of pregnancy will resume smoking during the first 6 months postpartum. Evidence suggests that changes in depressive symptoms, perceived stress, and concerns about weight may relate to postpartum smoking relapse.
This study was designed to prospectively evaluate the relationship of mood and weight concerns to postpartum smoking among women who quit smoking during pregnancy.
Pregnant women who had quit smoking (N=183) were recruited between February 2003 and November 2006. Women completed assessments of mood (depressive symptoms, perceived stress, positive and negative affect) and weight concerns during the third trimester of pregnancy and at 6, 12, and 24 weeks postpartum. Self-reported smoking status was verified by expired-air carbon monoxide and salivary cotinine at each assessment. Cox regression analyses in which mood and weight concerns were treated as time-dependent covariates were conducted in 2007 and 2009.
By 24 weeks postpartum, 65% of women had resumed smoking. Smoking-related weight concerns increased risk of relapse, and positive affect and self-efficacy for weight management without smoking decreased risk of relapse postpartum. Moreover, after controlling for variables previously related to postpartum relapse, weight concerns remained significantly related to smoking relapse.
Smoking-related weight concerns and positive affect increase the likelihood that a woman will resume smoking postpartum. Moreover, weight concerns appear to be salient even in the context of other factors shown to affect postpartum smoking. This study suggests that interventions may need to address women's weight concerns and mood to help sustain smoking abstinence after childbirth.
大多数因怀孕而戒烟的女性会在产后的头 6 个月内重新吸烟。有证据表明，抑郁症状、感知压力和对体重的担忧的变化可能与产后吸烟复吸有关。
本研究旨在前瞻性评估怀孕期间戒烟的女性的情绪和体重担忧与产后吸烟之间的关系。
2003 年 2 月至 2006 年 11 月期间招募了 183 名已戒烟的孕妇。女性在妊娠晚期以及产后 6、12 和 24 周时完成了情绪（抑郁症状、感知压力、积极和消极情绪）和体重担忧的评估。在每次评估时，通过呼出的一氧化碳和唾液可替宁来验证自我报告的吸烟状况。在 2007 年和 2009 年，使用 Cox 回归分析将情绪和体重担忧作为时间依赖的协变量进行分析。
到产后 24 周时，65%的女性重新开始吸烟。与吸烟相关的体重担忧增加了复吸的风险，而积极的情绪和没有吸烟的体重管理自我效能则降低了产后复吸的风险。此外，在控制了先前与产后复吸相关的变量后，体重担忧与吸烟复吸仍存在显著相关性。
与吸烟相关的体重担忧和积极情绪增加了女性产后重新吸烟的可能性。此外，即使在其他被证明会影响产后吸烟的因素的背景下，体重担忧似乎也很重要。这项研究表明，干预措施可能需要解决女性的体重担忧和情绪问题，以帮助她们在分娩后保持戒烟状态。
