Department of Chronic Disease Epidemiology, Yale University School of Public Health and Center for Interdisciplinary Research on AIDS, New Haven, Connecticut.
Department of Chronic Disease Epidemiology, Yale University School of Public Health and Center for Interdisciplinary Research on AIDS, New Haven, Connecticut.
J Adolesc Health. 2018 Aug;63(2):189-196. doi: 10.1016/j.jadohealth.2018.02.011. Epub 2018 Jul 1.
The burden of syndemics-which are clusters of overlapping risk factors that adversely impact health-has been previously evaluated among high-risk individuals, yet little is known regarding syndemics within the relationship context.
We evaluated concordant and discordant syndemic profiles among 296 pregnant couples and their actor-partner effects longitudinally from pregnancy to 1-year postpartum.
Syndemic score and severity were correlated across all time points for men and women. There was a significant difference in syndemic score (β = .2736, p = <.0001) and severity (β = .4282, p = <.0001) during pregnancy. For actor effects, we found score (β = .273, p = .002; β = .300, p = .005) and severity (β = .253, p = .004; β = .418, p = .001) were significantly associated across all time points for women. For men, only syndemic score predicted subsequent score at later time points (β = .393, p = <.001; β = .421, p = <.001). Severity was not significantly associated across time (β = .043, p = .566; β = .172, p = .066). For partner effects, we found women's syndemic risk to influence men's syndemic risk, while men had no significant effect on women's syndemic risk.
Pregnancy provides an opportunity to reduce syndemic burden among men and women. Couples-based prevention programs may serve to reduce syndemic risk for both partners, particularly during the postpartum period.
综合征是指多种重叠风险因素对健康产生不利影响的集群，此前曾在高危人群中对其进行了评估，但对于关系背景下的综合征知之甚少。
我们从怀孕到产后 1 年，对 296 对孕妇夫妇及其角色伴侣进行了纵向评估，以评估他们在怀孕期间是否存在一致和不一致的综合征特征及其作用。
男性和女性在所有时间点的综合征评分和严重程度均相关。在怀孕期间，综合征评分（β=0.2736，p<.0001）和严重程度（β=0.4282，p<.0001）存在显著差异。对于角色效应，我们发现女性在所有时间点的评分（β=0.273，p=0.002；β=0.300，p=0.005）和严重程度（β=0.253，p=0.004；β=0.418，p=0.001）均显著相关。对于男性，只有综合征评分可以预测后续时间点的评分（β=0.393，p<.001；β=0.421，p<.001）。严重程度在时间上没有显著相关性（β=0.043，p=0.566；β=0.172，p=0.066）。对于伴侣效应，我们发现女性的综合征风险会影响男性的综合征风险，而男性对女性的综合征风险没有显著影响。
怀孕为降低男性和女性的综合征负担提供了机会。基于夫妻的预防计划可能有助于降低双方的综合征风险，特别是在产后期间。
