Goodwin Renee D, Cheslack-Postava Keely, Nelson Deborah B, Smith Philip H, Wall Melanie M, Hasin Deborah S, Nomura Yoko, Galea Sandro
Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA; Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
Drug Alcohol Depend. 2017 Oct 1;179:159-166. doi: 10.1016/j.drugalcdep.2017.06.021. Epub 2017 Jul 18.
Despite success of public health-oriented tobacco control programs in lowering the smoking prevalence over the past several decades, it is unclear whether similar reductions in smoking have been experienced among pregnant women, especially in vulnerable groups such as those with major depression and/or lower socioeconomic status.
The purpose of this study is to examine the relationship between major depressive episode (MDE) and smoking among pregnant women overall, and by demographics and to estimate changes in the prevalence of cigarette smoking among pregnant women with and without MDE from 2005 to 2014.
Cigarette use among pregnant women with and without MDE was examined using logistic regression models in the National Survey on Drug Use and Health.
Prenatal smoking is more common among pregnant women with, compared to without, MDE (32.5% vs. 13.0%; (adjusted OR=2.50 (1.85, 3.40)), and greater disparities were revealed when also considering income, education and race. Over time, smoking during pregnancy increased significantly among women with MDE (35.9% to 38.4%; p=0.02)) and showed a decreasing trend among women without MDE (12.5% to 9.1%; p=0.07) from 2005 to 2014.
Over the past decade, smoking during pregnancy has increased among women experiencing a major depressive episode and is over four times more common among pregnant women with, than without, MDE. Disparities in smoking during pregnancy by MDE status and socioeconomic subgroups appear substantial. Given the multitude of risks associated with both MDE and smoking during the prenatal period, more work targeting this vulnerable and high-risk group is needed.
尽管过去几十年来以公共卫生为导向的烟草控制项目在降低吸烟率方面取得了成功，但尚不清楚孕妇吸烟率是否也有类似下降，尤其是在患有重度抑郁症和/或社会经济地位较低等弱势群体中。
本研究旨在探讨孕妇总体中重度抑郁发作（MDE）与吸烟之间的关系，并按人口统计学特征进行分析，同时估计2005年至2014年有和没有MDE的孕妇吸烟率的变化。
在全国药物使用和健康调查中，使用逻辑回归模型研究了有和没有MDE的孕妇的吸烟情况。
与没有MDE的孕妇相比，有MDE的孕妇产前吸烟更为常见（32.5%对13.0%；调整后的比值比=2.50（1.85，3.40）），在考虑收入、教育和种族因素时，差异更为明显。随着时间的推移，2005年至2014年期间，有MDE的女性孕期吸烟率显著上升（35.9%至38.4%；p=0.02），而没有MDE的女性则呈下降趋势（12.5%至9.1%；p=0.07）。
在过去十年中，经历重度抑郁发作的女性孕期吸烟率有所上升，有MDE的孕妇吸烟率是没有MDE孕妇的四倍多。MDE状态和社会经济亚组之间孕期吸烟的差异似乎很大。鉴于产前时期MDE和吸烟都存在诸多风险，需要针对这一弱势群体开展更多工作。
