Tong Van T, Farr Sherry L, Bombard Jennifer, DʼAngelo Denise, Ko Jean Y, England Lucinda J
Division of Reproductive Health and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, and the National Center for Birth Defects and Developmental Disabilities, Atlanta, Georgia.
Obstet Gynecol. 2016 Sep;128(3):562-70. doi: 10.1097/AOG.0000000000001595.
To describe prepregnancy smoking, prenatal smoking, and prenatal cessation among women reporting and not reporting depression or anxiety.
We analyzed cross-sectional data from the 2009-2011 Pregnancy Risk Assessment Monitoring System, a population-based survey of women with live births (N=34,633). Smoking status was defined as self-reported prepregnancy smoking (during the 3 months before pregnancy), prenatal smoking (during the last 3 months of pregnancy), and prenatal cessation (no smoking by the last 3 months among prepregnancy smokers). Depression and anxiety status was self-reported of having either condition or both during the 3 months before pregnancy. We compared smoking prevalence by self-reported depression and anxiety status using χ tests and adjusted prevalence ratios.
Overall, 16.9% of women in our sample reported depression, anxiety, or both during the 3 months before pregnancy. Compared with those who did not report, women who reported depression or anxiety had significantly higher prepregnancy (46.7% compared with 22.5%, P<.01) and prenatal smoking (27.5% compared with 10.5%, P<.01). A lower proportion of prepregnancy smokers who reported depression or anxiety quit smoking by the last 3 months of pregnancy than those who did not report (41.4% compared with 53.8%, P<.01). In adjusted analyses, women reporting depression or anxiety were 1.5 and 1.7 times more likely to smoke prepregnancy and prenatally, respectively, and less likely to quit smoking (adjusted prevalence ratio 0.86, 95% confidence interval 0.80-0.92).
Women who reported depression, anxiety, or both were more likely to smoke before and during pregnancy and less likely to quit smoking during the prenatal period. Screening recommendations for perinatal depression and anxiety provide an opportunity to identify a subpopulation of women who may have a higher prevalence of smoking and to provide effective tobacco cessation interventions and mental health care.
描述报告和未报告抑郁或焦虑的女性的孕前吸烟、孕期吸烟及孕期戒烟情况。
我们分析了2009 - 2011年妊娠风险评估监测系统的横断面数据，这是一项针对有活产婴儿女性的基于人群的调查（N = 34,633）。吸烟状况定义为自我报告的孕前吸烟（妊娠前3个月）、孕期吸烟（妊娠最后3个月）和孕期戒烟（孕前吸烟者在最后3个月不再吸烟）。抑郁和焦虑状况通过自我报告是否在妊娠前3个月患有其中一种或两种情况来确定。我们使用χ检验和调整后的患病率比比较了自我报告的抑郁和焦虑状况下的吸烟患病率。
总体而言，我们样本中的16.9%女性在妊娠前3个月报告有抑郁、焦虑或两者皆有。与未报告的女性相比，报告有抑郁或焦虑的女性孕前吸烟率显著更高（分别为46.7%和22.5%，P <.01），孕期吸烟率也显著更高（分别为27.5%和10.5%，P <.01）。报告有抑郁或焦虑的孕前吸烟者在妊娠最后3个月戒烟的比例低于未报告者（分别为41.4%和53.8%，P <.01）。在调整分析中，报告有抑郁或焦虑的女性孕前吸烟和孕期吸烟的可能性分别是未报告者的1.5倍和1.7倍，且戒烟可能性较小（调整后的患病率比为0.86，95%置信区间为0.80 - 0.92）。
报告有抑郁、焦虑或两者皆有的女性在孕前和孕期吸烟的可能性更大，且在孕期戒烟的可能性更小。围产期抑郁和焦虑的筛查建议为识别吸烟患病率可能更高的女性亚群体以及提供有效的戒烟干预和心理健康护理提供了机会。
