美国2008 - 2014年孕期严重心理困扰与吸烟情况
Serious Psychological Distress and Smoking During Pregnancy in the United States: 2008-2014.
作者信息
Goodwin Renee D, Cheslack-Postava Keely, Nelson Deborah B, Smith Philip H, Hasin Deborah S, Janevic Teresa, Bakoyiannis Nina, Wall Melanie M
机构信息
Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Queens, NY.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
出版信息
Nicotine Tob Res. 2017 May 1;19(5):605-614. doi: 10.1093/ntr/ntw323.
INTRODUCTION
The current study examined the relationship between acute (past 30 day) and recent (past year but not past 30 day) serious psychological distress (SPD) and smoking during pregnancy among women in the United States overall, stratified by demographic characteristics, and described the change in the prevalence of prenatal smoking among women with and without SPD, from 2008 to 2014.
METHODS
Data were drawn from the National Survey on Drug Use and Health (NSDUH), an annual cross-sectional study of US persons aged 12 and over. SPD and smoking in the past 30 days among pregnant women, aged 18 and older, were examined using logistic regression models. Heterogeneity in this association by demographic characteristics, trends over time, and level of cigarette consumption was also examined.
RESULTS
Prenatal smoking was common. Almost 40% of pregnant women with acute SPD reported smoking, 23% of pregnant women with recent SPD smoked, and 11.7% of pregnant women without recent SPD smoked. No significant change was found in the prevalence of prenatal smoking from 2008 to 2014 in any of these groups. Robust relationships were found between acute (OR = 5.05 [3.64-6.99]) and recent SPD (OR = 2.37 [1.74-3.24]) and smoking; these findings remained after adjusting for demographics.
CONCLUSIONS
SPD and smoking during pregnancy are strongly associated; this relationship is present across all sociodemographic groups and the prevalence of smoking in pregnancy has remained relatively unchanged over the past decade both in the presence and absence of SPD.
IMPLICATIONS
SPD and smoking in pregnancy are robustly linked; the prevalence of smoking in pregnancy is extremely high in women with SPD. Screening women with mental health problems for prenatal smoking, as well as screening pregnant smokers for mental health problems, seems warranted and may assist more women in seeking and utilizing treatment options. Efforts to reduce the prevalence of smoking during pregnancy might specifically target women with SPD, where the potential for impact is substantial.
引言
本研究调查了美国女性总体中急性（过去30天内）和近期（过去一年但非过去30天内）严重心理困扰（SPD）与孕期吸烟之间的关系，并按人口统计学特征进行分层，同时描述了2008年至2014年期间有和没有SPD的女性中产前吸烟患病率的变化。
方法
数据来自全国药物使用和健康调查（NSDUH），这是一项对12岁及以上美国人的年度横断面研究。使用逻辑回归模型检查了18岁及以上孕妇在过去30天内的SPD和吸烟情况。还研究了这种关联在人口统计学特征、随时间的趋势以及香烟消费水平方面的异质性。
结果
产前吸烟很常见。近40%的患有急性SPD的孕妇报告吸烟，23%的患有近期SPD的孕妇吸烟，11.7%的没有近期SPD的孕妇吸烟。在这些组中的任何一组中，2008年至2014年期间产前吸烟的患病率均未发现显著变化。发现急性（比值比=5.05[3.64 - 6.99]）和近期SPD（比值比=2.37[1.74 - 3.24]）与吸烟之间存在密切关系；在对人口统计学进行调整后，这些发现仍然成立。
结论
SPD与孕期吸烟密切相关；这种关系在所有社会人口学群体中都存在，并且在过去十年中，无论有无SPD，孕期吸烟的患病率都相对保持不变。
启示
SPD与孕期吸烟密切相关；患有SPD的女性孕期吸烟的患病率极高。对有心理健康问题的女性进行产前吸烟筛查，以及对吸烟的孕妇进行心理健康问题筛查，似乎是有必要的，并且可能有助于更多女性寻求和利用治疗方案。降低孕期吸烟患病率的努力可能特别针对患有SPD的女性，因为在这方面产生影响的潜力很大。
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