孕期自然戒烟女性的积极养育行为：预防干预的潜在目标线索。
Positive parenting behaviors in women who spontaneously quit smoking during pregnancy: Clues to putative targets for preventive interventions.
机构信息
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
出版信息
Neurotoxicol Teratol. 2018 May-Jun;67:18-24. doi: 10.1016/j.ntt.2018.02.003. Epub 2018 Mar 6.
BACKGROUND
While the majority of pregnant smokers do not respond to intervention, little is known about how a subset of pregnant smokers known as spontaneous quitters achieve sustained biologically-confirmed abstinence through delivery in the absence of intervention. We explore a developmental framework to address this question by viewing spontaneous quitting as an adaptive parenting behavior, facilitated by abilities necessary for sensitive parenting, or responsiveness. Utilizing existing data, we examined responsiveness from parenting assessments in women who exhibited a variety of smoking patterns during pregnancy, including spontaneous quitting.
METHODS
Participants were N = 305 pregnant women assessed for smoking prospectively and biochemically at 16 weeks, 28 weeks, delivery, and 4 weeks postpartum, then reassessed with their children 5 years later with directly-observed home- and lab-based measures of parenting. We used linear regression analysis to compare spontaneous quitters with women who exhibited other prenatal smoking patterns on parenting responsiveness, controlling for potential confounders.
RESULTS
In home-based observations, spontaneous quitters (n = 22) exhibited greater responsiveness with their children relative to intermittent pregnancy smokers [n = 70; β = 0.258, p = .022]; persistent pregnancy smokers [n = 66; β = 0.228, p = .040]; former smokers (quit before pregnancy) [n = 78; β = 266, p = .028]; and never smokers [n = 69; β = 0.312, p = .009]. Hypothesized differences were not observed in lab-based and self-report measures.
CONCLUSIONS
Putative protective characteristics in spontaneous quitters were captured in mother-child interactions at home, but not in lab-based and maternal report measures of responsiveness. Specification of these characteristics using prospective designs that oversample for spontaneous quitters is recommended to enable translation to preventive interventions.
背景
虽然大多数孕妇吸烟者对干预措施没有反应，但对于在没有干预的情况下通过分娩达到持续生物学确认的戒烟的孕妇中，一小部分被称为自发性戒烟者是如何做到这一点的，人们知之甚少。我们通过将自发性戒烟视为一种适应的育儿行为，利用育儿中需要的能力来解决这个问题，这些能力可以促进育儿的敏感性，即反应性。利用现有数据，我们检查了来自育儿评估的反应性，这些评估对象是在怀孕期间表现出各种吸烟模式的女性，包括自发性戒烟者。
方法
参与者是 305 名孕妇，她们在怀孕 16 周、28 周、分娩时和产后 4 周进行前瞻性和生物化学评估，然后在 5 年后与她们的孩子一起进行直接观察的家庭和实验室育儿测量。我们使用线性回归分析比较了自发性戒烟者和其他产前吸烟模式的女性在育儿反应性上的差异，同时控制了潜在的混杂因素。
结果
在家庭观察中，与间歇性妊娠吸烟者（n=70；β=0.258，p=0.022）、持续妊娠吸烟者（n=66；β=0.228，p=0.040）、以前吸烟者（在怀孕前戒烟）（n=78；β=266，p=0.028）和从不吸烟者（n=69；β=0.312，p=0.009）相比，自发性戒烟者（n=22）与孩子的互动中表现出更高的反应性。在实验室和自我报告的反应性测量中没有观察到假设的差异。
结论
在家庭互动中捕捉到了自发性戒烟者的潜在保护特征，但在实验室和母亲报告的反应性测量中没有观察到这些特征。建议使用前瞻性设计对这些特征进行规范，这些设计对自发性戒烟者进行了抽样，以便将其转化为预防干预措施。
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