Massey Suena H, Bublitz Margaret H, Magee Susanna R, Salisbury Amy, Niaura Raymond S, Wakschlag Lauren S, Stroud Laura R
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 1000, Chicago, IL 60611, USA,; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19th Floor, Chicago, IL 60611, USA.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA.
Addict Behav. 2015 Jun;45:51-6. doi: 10.1016/j.addbeh.2015.01.028. Epub 2015 Jan 20.
Smoking cessation during pregnancy may reflect altruistic motives on behalf of the unborn baby. We test the hypothesis that pregnancy quitters have higher maternal-fetal attachment than persistent smokers, and secondarily explore how maternal-fetal attachment differs among non-smokers, pregnancy quitters, and persistent smokers.
Participants were 156 women in the Behavior and Mood in Babies and Mothers study who provided report of smoking throughout pregnancy via timeline follow back interviews, with salivary cotinine confirmation of reported cessation at 30 and 35 week gestation, and postpartum day one. Maternal Fetal Attachment Scale total and subscale scores (role-taking, differentiation of self from fetus, interaction with fetus, attributing characteristics to fetus, giving of self) were examined among non-smokers, pregnancy quitters, and persistent smokers.
At 30 weeks, pregnancy quitters scored higher on the 'giving of self' subscale compared to persistent smokers (21.6±2.4 versus 19.9±2.9; p=.004). Maternal 'giving of self' also differentiated pregnancies exposed to cigarette smoking from those without exposure from 30 weeks through delivery (19.9±2.9 versus 21.2±2.2; p=.002). Controlling for age, income, unemployment, gravida, and father's smoking status, 'giving of self' differentiated pregnancy quitters from persistent smokers [OR=5.144; 95% C.I. 1.509 - 17.538; B (SE)=1.638 (.626); p=.009].
Women who reported a greater desire to maintain their personal health for the health of their fetus were more likely to quit smoking during pregnancy. Implications of findings for interventions and understanding mechanisms of risk are discussed.
孕期戒烟可能反映出为未出生婴儿着想的利他动机。我们检验这样一个假设，即孕期戒烟者的母婴依恋程度高于持续吸烟者，其次探讨非吸烟者、孕期戒烟者和持续吸烟者之间母婴依恋的差异。
参与者为156名参与“母婴行为与情绪”研究的女性，她们通过时间线回溯访谈报告了整个孕期的吸烟情况，并在妊娠30周和35周以及产后第一天通过唾液可替宁确认报告的戒烟情况。在非吸烟者、孕期戒烟者和持续吸烟者中检查母婴依恋量表的总分和子量表得分（角色承担、自我与胎儿的区分、与胎儿的互动、赋予胎儿特征、自我付出）。
在30周时，孕期戒烟者在“自我付出”子量表上的得分高于持续吸烟者（21.6±2.4对19.9±2.9；p = 0.004）。从30周直至分娩，母亲的“自我付出”也区分了暴露于吸烟环境的妊娠和未暴露于吸烟环境的妊娠（19.9±2.9对21.2±2.2；p = 0.002）。在控制了年龄、收入、失业状况、孕次和父亲的吸烟状况后，“自我付出”区分了孕期戒烟者和持续吸烟者[比值比=5.144；95%置信区间1.509 - 17.538；B（标准误）=1.638（0.626）；p = 0.009]。
报告为了胎儿健康更渴望保持自身健康的女性在孕期更有可能戒烟。讨论了研究结果对干预措施以及理解风险机制的意义。
