Hetherington Erin, Doktorchik Chelsea, Premji Shahirose S, McDonald Sheila W, Tough Suzanne C, Sauve Reg S
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
Paediatr Perinat Epidemiol. 2015 Nov;29(6):523-35. doi: 10.1111/ppe.12225. Epub 2015 Sep 1.
Additional social support is often recommended for women during the prenatal period to optimise birth outcomes, specifically to avoid preterm birth. Social support is thought to act in one of two ways: by reducing stress and anxiety, or by providing coping mechanisms for women with high stress. However, evidence in this area is mixed. The purpose of this meta-analysis is to determine if low levels of social support are associated with an increased risk for preterm birth.
Six databases were searched for randomised control trials and cohort studies regarding social support and preterm birth with no limits set on date or language. Inclusion criteria included the use of a validated instrument to measure social support, and studies conducted in high-income or high-middle-income countries.
There were 3467 records retrieved, 16 of which met the inclusion criteria. Eight studies (n = 14 630 subjects) demonstrated a pooled odds ratio (OR) of 1.22 (95% CI 0.84, 1.76) for preterm birth in women with low social support compared with high social support. Among women with high stress levels, two studies (n = 6374 subjects) yielded a pooled OR of 1.52 (95% CI 1.18, 1.97). The results of six studies could not be pooled due to incompatibility of outcome measures.
There is no evidence for a direct association between social support and preterm birth. Social support, however, may provide a buffering mechanism between stress and preterm birth.
通常建议在孕期为女性提供额外的社会支持，以优化分娩结局，特别是避免早产。社会支持被认为通过两种方式之一发挥作用：减轻压力和焦虑，或为压力大的女性提供应对机制。然而，该领域的证据并不一致。本荟萃分析的目的是确定低水平的社会支持是否与早产风险增加有关。
检索了六个数据库，以查找关于社会支持和早产的随机对照试验和队列研究，对日期或语言没有限制。纳入标准包括使用经过验证的工具来测量社会支持，以及在高收入或高中等收入国家进行的研究。
共检索到3467条记录，其中16条符合纳入标准。八项研究（n = 14630名受试者）表明，与社会支持水平高的女性相比，社会支持水平低的女性早产的合并比值比（OR）为1.22（95%CI 0.84，1.76）。在压力水平高的女性中，两项研究（n = 6374名受试者）得出的合并OR为1.52（95%CI 1.18，1.97）。由于结局测量不兼容，六项研究的结果无法合并。
没有证据表明社会支持与早产之间存在直接关联。然而，社会支持可能在压力和早产之间提供一种缓冲机制。
