健康的结构和中介决定因素与早产之间的关系。
Relationship between Structural and Intermediary Determinants of Health and Preterm Delivery.
作者信息
Dolatian Mahrokh, Mirabzadeh Arash, Forouzan Ameneh Setareh, Sajjadi Homeira, Alavimajd Hamid, Mahmoodi Zohreh, Moafi Farnoosh
机构信息
Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran ; Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
出版信息
J Reprod Infertil. 2014 Apr;15(2):78-86.
BACKGROUND
Preterm birth is a major health problem that leads to infant morbidity and mortality. The main goal of this study was to find the relationship between social determinants of health and preterm delivery.
METHODS
A prospective longitudinal cohort study was carried out on 500 pregnant women in their 24th to 28th gestational weeks in 2012. The pregnant women filled out a self-report questionnaire on the structural determinant, perceived stress, and perceived social support. The participants were followed up until labor and the data about mother and the newborn were collected after labor. The data were analyzed by SPSS 21 and Lisrel 8.8 software programs using pathway analysis.
RESULTS
The final path model fit well (CFI=0.96; RMSEA=0.060). Path analysis showed that among structural factors, income had a direct effect (β=0.06) and the factors of income (β=0.00594), number of children (family size) (β=-0.024), as well as mother's education (β=-0.0084) had the greatest overall effect on gestational age at birth respectively. Also, the results showed that among intermediate factors of social determinants of health, stress in the direct path (β=-0.12) and among the overall effects, the perceived stress (β=-0.12) and perceived social support (β=0.0396) affected the gestational age at birth.
CONCLUSION
The current study showed that some structural and intermediary determinants such as income and perceived stress had an effect on preterm labor.
背景
早产是一个导致婴儿发病和死亡的主要健康问题。本研究的主要目的是找出健康的社会决定因素与早产之间的关系。
方法
2012年对500名妊娠24至28周的孕妇进行了一项前瞻性纵向队列研究。孕妇填写了一份关于结构决定因素、感知压力和感知社会支持的自我报告问卷。对参与者进行随访直至分娩，并在分娩后收集有关母亲和新生儿的数据。使用路径分析，通过SPSS 21和Lisrel 8.8软件程序对数据进行分析。
结果
最终路径模型拟合良好（CFI = 0.96；RMSEA = 0.060）。路径分析表明，在结构因素中，收入有直接影响（β = 0.06），收入因素（β = 0.00594）、子女数量（家庭规模）（β = -0.024）以及母亲教育程度（β = -0.0084）分别对出生时的孕周有最大的总体影响。此外，结果表明，在健康的社会决定因素的中间因素中，直接路径中的压力（β = -0.12）以及在总体影响中，感知压力（β = -0.12）和感知社会支持（β = 0.0396）影响出生时的孕周。
结论
当前研究表明，一些结构和中间决定因素，如收入和感知压力，对早产有影响。
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