童年时期家庭优势对青少年怀孕的保护作用及其长期心理社会后果。
The Protective Effect of Family Strengths in Childhood against Adolescent Pregnancy and Its Long-Term Psychosocial Consequences.
作者信息
Hillis Susan D, Anda Robert F, Dube Shanta R, Felitti Vincent J, Marchbanks Polly A, Macaluso Maurizio, Marks James S
出版信息
Perm J. 2010 Fall;14(3):18-27. doi: 10.7812/TPP/10-028.
BACKGROUND
Few reports have addressed associations between family strengths during childhood and adolescent pregnancy and its consequences. We examined relationships among a number of childhood family strengths and adolescent pregnancy, risk behavior, and psychosocial consequences after adolescent pregnancy.
METHODS
Our retrospective cohort of 4648 women older than 18 years (mean age, 56 years) received primary care in San Diego, CA. Outcomes included adolescent pregnancy and psychosocial consequences compared with number of the following childhood family strengths: family closeness, support, loyalty, protection, love, importance, and responsiveness to health needs.
RESULTS
Of the cohort, 3082 participants (66%) reported 6 or 7 categories of childhood family strengths. Teen pregnancy occurred in 39%, 33%, 30%, 25%, 24%, 21%, and 19% of those with 0 or 1, 2, 3, 4, 5, 6, and 7 childhood family strengths, respectively (p for trend < 0.00001). When childhood abuse and household dysfunction were present, adjusted odds ratios (ORs) for adolescent pregnancy demonstrated an increasingly protective effect as numbers of childhood family strengths increased from 0 or 1 to 2 or 3, 4 or 5, and 6 or 7 (1.0 to 0.80), (1.0 to 0.80, 0.60, and 0.54, respectively). These findings were partly explained by progressive delays in initiation of sexual activity as the number of childhood family strengths increased. Adjusted ORs for psychosocial problem occurring decades later decreased as the number of childhood family strengths increased from 0 or 1 to 2 or 3, 4 or 5, and 6 or 7 (job problems, 1.0, 0.8, 0.6, 0.4; family problems, 1.0, 1.1, 0.7, 0.6; financial problems, 1.0, 0.9, 0.9, 0.6; high stress, 1.0, 1.1, 0.9, 0.8; uncontrollable anger, 1.0, 0.7, 0.7, 0.4).
CONCLUSIONS
Childhood family strengths are strongly protective against adolescent pregnancy, early initiation of sexual activity, and long-term psychosocial consequences.
背景
很少有报告探讨童年时期的家庭优势与青少年怀孕及其后果之间的关联。我们研究了一系列童年家庭优势与青少年怀孕、风险行为以及青少年怀孕后的心理社会后果之间的关系。
方法
我们对加利福尼亚州圣地亚哥4648名18岁以上（平均年龄56岁）的女性进行了回顾性队列研究。将青少年怀孕和心理社会后果作为结果，与以下童年家庭优势的数量进行比较：家庭亲密程度、支持、忠诚、保护、爱、重要性以及对健康需求的响应性。
结果
在该队列中，3082名参与者（66%）报告有6或7类童年家庭优势。童年家庭优势为0或1、2、3、4、5、6和7类的参与者中，青少年怀孕的发生率分别为39%、33%、30%、25%、24%、21%和19%（趋势p<0.00001）。当存在童年期虐待和家庭功能障碍时，随着童年家庭优势的数量从0或1增加到2或3、4或5以及6或7，青少年怀孕的调整优势比（OR）显示出越来越强的保护作用（分别为1.0至0.80），（1.0至0.80、0.60和0.54）。随着童年家庭优势数量的增加，性活动开始时间逐渐延迟，这部分解释了这些发现。几十年后出现心理社会问题的调整OR随着童年家庭优势的数量从0或1增加到2或3、4或5以及6或7而降低（工作问题，1.0、0.8、0.6、0.4；家庭问题，1.0、1.1、0.7、0.6；经济问题，1.0、0.9、0.9、0.6；高压力，1.0、1.1、0.9、0.8；无法控制的愤怒，1.0、0.7、0.7、0.4）。
结论
童年家庭优势对青少年怀孕、过早开始性活动以及长期心理社会后果具有很强的保护作用。
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