Cheng Erika R, Rifas-Shiman Sheryl L, Perkins Meghan E, Rich-Edwards Janet Wilson, Gillman Matthew W, Wright Rosalind, Taveras Elsie M
1 Section of Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine , Indianapolis, Indiana.
2 Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston, Massachusetts.
J Womens Health (Larchmt). 2016 Jul;25(7):672-9. doi: 10.1089/jwh.2015.5462. Epub 2016 Feb 1.
While there has been considerable attention given to the multitude of maternal factors that contribute to perinatal conditions and poor birth outcomes, few studies have aimed to understand the impact of fathers or partners. We examined associations of antenatal partner support with psychological variables, smoking behavior, and pregnancy outcomes in two socioeconomically distinct prebirth cohorts.
Data were from 1764 women recruited from an urban-suburban group practice (Project Viva) and 877 women from urban community health centers (Project ACCESS), both in the Boston area. Antenatal partner support was assessed by the Turner Support Scale. Multivariable linear and logistic regression analyses determined the impact of low antenatal partner support on the outcomes of interest.
In early pregnancy, 6.4% of Viva and 23.0% of ACCESS participants reported low partner support. After adjustment, low partner support was cross-sectionally associated with high pregnancy-related anxiety in both cohorts (Viva AOR 1.8; 95% CI: 1.0-3.4 and ACCESS AOR 1.9; 95% CI: 1.1-3.3) and with depression in ACCESS (AOR 1.9; 95% CI: 1.1-3.3). In Viva, low partner support was also related to depression mid-pregnancy (AOR 3.1; 95% CI: 1.7-5.7) and to smoking (AOR 2.2; 95% CI: 1.3-3.8). Birth weight, gestational age, and fetal growth were not associated with partner support.
This study of two economically and ethnically distinct cohorts in the Boston area highlights higher levels of antenatal anxiety, depression, and smoking among pregnant women who report low partner support. Partner support may be an important and potentially modifiable target for interventions to improve pregnancy outcomes.
虽然人们对众多导致围产期状况和不良分娩结局的母亲因素给予了相当多的关注,但很少有研究旨在了解父亲或伴侣的影响。我们在两个社会经济状况不同的产前队列中,研究了产前伴侣支持与心理变量、吸烟行为及妊娠结局之间的关联。
数据来自波士顿地区城市-郊区综合诊所招募的1764名女性(活力项目)以及城市社区健康中心的877名女性(接入项目)。产前伴侣支持通过特纳支持量表进行评估。多变量线性和逻辑回归分析确定了低水平产前伴侣支持对相关结局的影响。
在妊娠早期,活力项目6.4%的参与者和接入项目23.0%的参与者报告称伴侣支持水平低。调整后,两个队列中低伴侣支持均与高妊娠相关焦虑呈横断面关联(活力项目优势比1.8;95%置信区间:1.0 - 3.4;接入项目优势比1.9;95%置信区间:1.1 - 3.3),接入项目中低伴侣支持还与抑郁相关(优势比1.9;95%置信区间:1.1 - 3.3)。在活力项目中,低伴侣支持还与妊娠中期抑郁相关(优势比3.1;95%置信区间:1.7 - 5.7)以及与吸烟相关(优势比2.2;95%置信区间:1.3 - 3.8)。出生体重、孕周和胎儿生长与伴侣支持无关。
这项对波士顿地区两个经济和种族不同队列的研究表明,报告伴侣支持水平低的孕妇中,产前焦虑、抑郁和吸烟水平较高。伴侣支持可能是改善妊娠结局干预措施的一个重要且可能可改变的目标。