Henriques Ana, Alves Luís, Alves Elisabete, Silva Susana, Barros Henrique, Azevedo Ana
EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal,
Matern Child Health J. 2015 Jun;19(6):1237-44. doi: 10.1007/s10995-014-1629-2.
Advantaged socioeconomic position (SEP) is associated with lower body image satisfaction (BIS) among women. However, motherhood and social trajectory (an individual's path from childhood SEP to adulthood SEP) could change this relationship. We aimed to assess the association between social trajectory and BIS immediately before getting pregnant in primiparous and multiparous mothers of a birth cohort. The birth cohort Generation XXI was assembled after delivery, in Porto, in 2005-2006. This analysis includes 5,470 women. Women's and their parents' education were used as indicators of adulthood and childhood SEP, respectively. Social trajectory was classified as stable-high, upward, stable-low, downward, according to both education variables. BIS was assessed with Stunkard silhouettes immediately after birth as the difference between perceived body size before the index pregnancy and ideal body size. Odds ratios (OR) between social trajectory and BIS were computed using multinomial logistic regression (women satisfied with body image were the outcome reference category), adjusting for age and prepregnancy body mass index. In primiparous women, no association was found between childhood SEP, adulthood SEP or social trajectory and feeling too small or too large regarding their ideal figure. Multiparous women with a downward social trajectory presented a higher likelihood of dissatisfaction [too small: adjusted OR 2.21, 95 % confidence interval (95 % CI) 1.10-4.46; too large: adjusted OR 1.64, 95 % CI 1.07-2.51]. Downward social trajectory was associated with a higher likelihood of dissatisfaction with body image in multiparae, while there was no effect among primiparae.
社会经济地位优越(SEP)与女性较低的身体形象满意度(BIS)相关。然而,母亲身份和社会轨迹(个体从童年SEP到成年SEP的路径)可能会改变这种关系。我们旨在评估一个出生队列中初产妇和经产妇在怀孕前即刻社会轨迹与BIS之间的关联。二十一世纪出生队列于2005 - 2006年在波尔图分娩后组建。该分析纳入了5470名女性。女性及其父母的教育程度分别用作成年期和童年期SEP的指标。根据这两个教育变量,社会轨迹被分类为稳定高、上升、稳定低、下降。产后即刻使用斯图卡德轮廓图评估BIS,即本次妊娠前感知的身体大小与理想身体大小之间的差异。使用多项逻辑回归计算社会轨迹与BIS之间的优势比(OR)(身体形象满意的女性作为结局参考类别),并对年龄和孕前体重指数进行校正。在初产妇中,未发现童年SEP、成年SEP或社会轨迹与对理想身材感觉过小或过大之间存在关联。社会轨迹下降的经产妇出现不满的可能性更高[过小:校正后OR 2.21,95%置信区间(95%CI)1.10 - 4.46;过大:校正后OR 1.64,95%CI 1.07 - 2.51]。社会轨迹下降与经产妇对身体形象不满的较高可能性相关,而在初产妇中则无此影响。