School of Social Work, University of Washington, Seattle, WA 98105-6299, USA.
J Womens Health (Larchmt). 2012 Jun;21(6):634-42. doi: 10.1089/jwh.2011.2766. Epub 2011 Dec 13.
Numerous studies find that socially disadvantaged women are more likely than socially advantaged women to deliver infants that weigh less than normal and/or are born weeks prior to their due date. However, little is known about the pathways that link maternal social disadvantage to birth outcomes. Using data from a prospective cohort study, we examined whether antenatal psychosocial stress, substance use, and maternal health conditions in pregnancy mediated the pathway between maternal social disadvantage and birth outcomes.
Analyses used structural equation modeling to examine data from a community clinic-based sample (n=2168) of pregnant women who completed questionnaires assessing psychosocial functioning and health behaviors as well as sociodemographic characteristics, which were matched with subsequent birth outcome data.
Analyses revealed maternal social disadvantage predicted poorer birth outcomes through a mediated pathway including maternal health conditions in pregnancy.
The findings demonstrate that maternal social disadvantage is associated with poor health status in pregnancy, which in turn adversely affects birth outcomes. Results argue for more systematic attention to the roles of social disadvantage, including life course perspectives that trace social disadvantage prior to and through pregnancy.
许多研究发现，社会地位较低的女性比社会地位较高的女性更有可能生下体重较轻或早产的婴儿。然而，人们对将母亲社会劣势与生育结果联系起来的途径知之甚少。本研究使用前瞻性队列研究的数据，检验了产前心理社会压力、物质使用和妊娠期间的母体健康状况是否在母亲社会劣势与生育结果之间的途径中起中介作用。
使用结构方程模型分析了一项基于社区诊所的样本（n=2168）的孕妇问卷调查数据，该研究评估了心理社会功能和健康行为以及社会人口特征，这些数据与随后的生育结果数据相匹配。
分析表明，母亲的社会劣势通过包括妊娠期间母体健康状况在内的中介途径预测较差的生育结果。
研究结果表明，母亲的社会劣势与妊娠期间的健康状况较差有关，进而对生育结果产生不利影响。研究结果表明，需要更系统地关注社会劣势的作用，包括追溯到怀孕前和怀孕期间的社会劣势的生命历程观点。
