Lee King Patricia A, Duan Lei, Amaro Hortensia
School of Social Work, University of Southern California, 1150 South Olive Street, Los Angeles, CA, 90015, USA,
Matern Child Health J. 2015 Jan;19(1):180-7. doi: 10.1007/s10995-014-1508-x.
We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran-Mantel-Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders.
我们调查了患有共病（定义为在治疗开始时存在药物滥用、精神疾病和创伤）的孕妇与未怀孕女性相比的社会脆弱性和行为健康临床特征（症状严重程度），以及人际虐待在孕妇临床表现中的作用。我们的目标是为初级医疗保健提供者提供深入了解行为健康风险高的孕妇的需求，以便在具有长期影响的关键机会窗口期间更好地为她们服务。我们对来自美国九个地点的“女性、共病与暴力研究”中参加治疗项目的女性的基线数据进行了横断面二次分析。我们使用方差分析和 Cochr an - Mantel - Haenszel 统计分析来比较152名孕妇和2577名未怀孕女性之间，以及有和没有当前人际虐待的孕妇之间社会脆弱性指标的均值和频率、基线成瘾严重程度指数、心理健康简短症状量表和创伤后应激诊断量表得分。与未怀孕女性相比，孕妇在治疗开始时表现出更多的社会脆弱性，但行为健康临床特征更好。当前的人际虐待与孕妇心理健康和创伤症状的增加有关，但与酒精或药物滥用严重程度无关。孕期是筛查和干预社会脆弱性和共病等已知会影响妊娠和婴儿结局的因素的重要时期；对于患有共病的孕妇来说，社会和行为健康服务尤为重要。
