Shwarz M, Collins B N, Nair U S
Health Behavior Research Center, Department of Public Health, Philadelphia, PA, USA.
Ment Health Fam Med. 2012 Dec;9(4):275-87.
Introduction Maternal depressive symptoms increase the risk of poor maternal and child health outcomes, and are a primary barrier to health behaviour change. Social cognitive theory can guide our understanding of risk factors that may have an impact on maternal depressive symptoms. The aim of this paper was to understand the correlates of maternal depressive symptoms among low-income African American smokers completing a 16-week intervention trial to reduce young children's second-hand smoke exposure (SHSe). Methods This study presents a secondary analysis of depression symptoms among 227 maternal smokers completing the SHSe-reduction trial. The end-of-treatment Center of Epidemiologic Studies Depression Scale (CES-D) score was used to assess depressive symptoms (dichotomised as 0 = score of < 16 and 1 = score of ≥ 16). Multivariate logistic regression analysis was used to test the one-way hypothesis that odds of significant depressive symptoms would be associated with greater total number of household smokers, greater number of paediatric sick visits, greater daily exposure of child to cigarette smoke by their mother, greater life-event stress, and lower social support, marital status, employment status and level of educational attainment. Results Number of household smokers (OR = 1.57, P = 0.049), social support (OR = 0.88, P < 0.001) and life-event stress (OR = 1.04, P = 0.001) predicted significant maternal depressive symptoms; all other variables were not significant predictors in the model. Conclusion Number of household smokers is a novel risk factor for understanding significant maternal depressive symptoms in the context of a childhood SHSe-reduction trial. Improving our understanding of the household-level social milieu in the context of SHSe-reduction interventions will assist in reducing the risk of maternal depressive symptoms.
引言 孕产妇抑郁症状会增加母婴健康不良后果的风险，并且是健康行为改变的主要障碍。社会认知理论可以指导我们理解可能影响孕产妇抑郁症状的风险因素。本文旨在了解完成一项为期16周的减少幼儿二手烟暴露（SHSe）干预试验的低收入非裔美国吸烟者中孕产妇抑郁症状的相关因素。方法 本研究对227名完成SHSe减少试验的孕产妇吸烟者的抑郁症状进行了二次分析。采用治疗结束时的流行病学研究中心抑郁量表（CES-D）评分来评估抑郁症状（分为0 = 得分<16和1 = 得分≥16）。多变量逻辑回归分析用于检验单向假设，即显著抑郁症状的几率与家庭吸烟者总数增加、儿科就诊次数增加、孩子每天母亲吸烟的暴露量增加、生活事件压力增加以及社会支持、婚姻状况、就业状况和教育程度降低有关。结果 家庭吸烟者数量（OR = 1.57，P = 0.049）、社会支持（OR = 0.88，P < 0.001）和生活事件压力（OR = 1.04，P = 0.001）可预测孕产妇显著抑郁症状；模型中的所有其他变量均不是显著预测因素。结论 在减少儿童SHSe的试验背景下，家庭吸烟者数量是理解孕产妇显著抑郁症状的一个新的风险因素。在减少SHSe干预措施的背景下，提高我们对家庭层面社会环境的理解将有助于降低孕产妇抑郁症状的风险。
