Burns Elizabeth R, Farr Sherry L, Howards Penelope P
MMWR Morb Mortal Wkly Rep. 2015 Mar 13;64(9):247-51.
Epidemiologic studies suggest that prenatal stress is associated with preterm birth, low birth weight, and peripartum anxiety and depressive symptoms. The most recent population-based study, assessing trends in stress experienced in the year before an infant's birth, used 1990-1995 data from 11 states participating in the Pregnancy Risk Assessment Monitoring System (PRAMS). That study found that 64% of women surveyed reported experiencing at least one stressful life event (SLE), although the prevalence declined slightly over the study period. PRAMS data for 2000-2010 were used to examine more recent trends and to determine if the prevalence of SLEs has continued to decrease in the past decade. Additionally, 2010 data were used to determine the extent that maternal demographics and state of residence are associated with SLEs. This report describes the results of those analyses, which found that most women in the sample reported experiencing ≥1 SLEs in the year before their infant's birth, although the prevalence of experiencing SLEs decreased during 2000-2010. In 2010, based on data from 27 states, 70.2% of women reported ≥1 SLEs. The mean number of SLEs was 1.81, ranging from 1.41 in New York City to 2.26 in Oklahoma. SLEs were most frequently financial. Prevalence of SLEs varied by PRAMS reporting site and maternal demographics. Younger, less educated, unmarried, and Medicaid-covered women had the highest prevalence of SLEs. Public health practitioners and clinicians can use the information on trends and risk factors for SLEs to determine the likelihood that pregnant women might benefit from screening for stressors during pregnancy.
流行病学研究表明,产前压力与早产、低出生体重以及围产期焦虑和抑郁症状有关。最近一项基于人群的研究评估了婴儿出生前一年所经历压力的趋势,该研究使用了参与妊娠风险评估监测系统(PRAMS)的11个州1990 - 1995年的数据。该研究发现,64%接受调查的女性报告称至少经历过一次生活应激事件(SLE),尽管在研究期间患病率略有下降。2000 - 2010年的PRAMS数据用于研究更近的趋势,并确定在过去十年中SLE的患病率是否持续下降。此外,2010年的数据用于确定孕产妇人口统计学特征和居住州与SLE之间的关联程度。本报告描述了这些分析的结果,结果发现样本中的大多数女性报告在其婴儿出生前一年经历过≥1次SLE,尽管在2000 - 2010年期间经历SLE的患病率有所下降。2010年,根据27个州的数据,70.2%的女性报告经历过≥1次SLE。SLE的平均次数为1.81次,从纽约市的1.41次到俄克拉荷马州的2.26次不等。SLE最常见的是经济方面的。SLE的患病率因PRAMS报告地点和孕产妇人口统计学特征而异。年轻、受教育程度较低、未婚以及参加医疗补助计划的女性SLE患病率最高。公共卫生从业者和临床医生可以利用有关SLE趋势和风险因素的信息,来确定孕妇在孕期接受压力源筛查可能受益的可能性。