Luecken Linda J, Jewell Shannon L, MacKinnon David P
From the Department of Psychology, Arizona State University, Tempe, Arizona.
Psychosom Med. 2016 Nov/Dec;78(9):1104-1113. doi: 10.1097/PSY.0000000000000391.
The postpartum period represents a crucial transition period in which weight gain or loss can affect lifetime obesity risk. This study examined the prevalence of obesity and the influence of childhood abuse and family conflict on postpartum weight among low-income Mexican-origin women. Depressive symptoms and partner support were evaluated as mediators.
At a prenatal assessment, low-income Mexican-origin women (N = 322; mean [SD] age, 27.8 [6.5]) reported on childhood abuse and family conflict. Weight was measured 7 times between 6 weeks and 2 years postpartum and calculated as body mass index. Regression and growth models were used to estimate the impact of childhood abuse, childhood family conflict, partner support, and depressive symptoms on weight and weight change.
Higher family conflict predicted higher weight across the first (β = .12; p = .037) and second (β = .16; p = .012) postpartum years. Family conflict (β = .17; p = .018) and low partner support (β = -.16; p = .028) also predicted increasing weight in the first year. Partner support partially mediated the effect of childhood abuse on weight change in the first year (p = .031). Depressive symptomatology mediated the effects of childhood abuse and family conflict on weight status in the second year (abuse: p = .005; conflict: p = .023).
For low-income Mexican-origin women with a history of childhood abuse or high family conflict, depression and low partner support may be important targets for obesity prevention efforts in the postpartum period.
产后时期是一个关键的过渡阶段,在此期间体重增加或减少会影响终生肥胖风险。本研究调查了低收入墨西哥裔女性肥胖的患病率,以及童年期受虐和家庭冲突对产后体重的影响。评估了抑郁症状和伴侣支持作为中介因素。
在产前评估时,低收入墨西哥裔女性(N = 322;平均[标准差]年龄为27.8[6.5]岁)报告了童年期受虐情况和家庭冲突。在产后6周和2年期间测量了7次体重,并计算体重指数。采用回归模型和生长模型来估计童年期受虐、童年家庭冲突、伴侣支持和抑郁症状对体重及体重变化的影响。
较高的家庭冲突预示着产后第一年(β = 0.12;p = 0.037)和第二年(β = 0.16;p = 0.012)体重更高。家庭冲突(β = 0.17;p = 0.018)和较低的伴侣支持(β = -0.16;p = 0.028)也预示着第一年体重增加。伴侣支持部分介导了童年期受虐对第一年体重变化的影响(p = 0.031)。抑郁症状介导了童年期受虐和家庭冲突对第二年体重状况的影响(受虐:p = 0.005;冲突:p = 0.023)。
对于有童年期受虐史或家庭冲突较高的低收入墨西哥裔女性,抑郁和较低的伴侣支持可能是产后肥胖预防工作的重要目标。