妊娠和早产的不良心理社会因素。
Adverse psychosocial factors in pregnancy and preterm delivery.
机构信息
Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
出版信息
Paediatr Perinat Epidemiol. 2021 Sep;35(5):519-529. doi: 10.1111/ppe.12756. Epub 2021 Mar 5.
BACKGROUND
Mental health symptoms, stress, and low psychosocial resources are associated with preterm delivery. It is unknown if there are groups of women who experience similar patterns of these adverse psychosocial factors during pregnancy and if the risk of preterm delivery differs among these groups.
OBJECTIVE
To identify groups of women with similar patterns of adverse psychosocial factors during pregnancy and determine whether the risk of preterm delivery differs among these groups.
METHODS
Spontaneous Prematurity and Epigenetics of the Cervix (SPEC) is a prospective cohort study of pregnant women, aged 18 and older. In this analysis, we included women who enrolled after 24 August 2014 and delivered by 20 January 2019. As women could enrol more than once, our cohort included 774 women with 787 pregnancies. We conducted a latent class analysis to identify groups of women with similar patterns of adverse psychosocial factors during pregnancy based on their responses to measures assessing depression, perceived stress, anxiety (pregnancy-related and generalised), stressful life events, resilience, and social support (partner and friend/family). After identifying the latent classes, we used log-binomial regression to compare the incidence of preterm delivery among the classes.
RESULTS
The median age among participants was 33.2 years (interquartile range 30.3-36.3), and the majority were non-Hispanic white (56.9%). We identified three classes of adverse psychosocial factors (few, some, and many factors). In total, 63 (8.0%) pregnancies resulted in a preterm delivery. Compared to participants with few factors, the risk of preterm delivery was no different among participants with some (RR 1.23, 95% CI 0.68, 2.25) and many adverse factors (RR 1.62, 95% CI 0.73, 3.62).
CONCLUSIONS
We identified three groups of pregnant women with similar patterns of adverse psychosocial factors. We did not observe a difference in the risk of preterm delivery among the classes.
背景
精神健康症状、压力和较低的心理社会资源与早产有关。目前尚不清楚是否存在在怀孕期间经历类似的这些不良心理社会因素模式的女性群体，以及这些群体之间早产的风险是否存在差异。
目的
确定在怀孕期间具有相似的不良心理社会因素模式的女性群体，并确定这些群体之间早产的风险是否存在差异。
方法
自发性早产和宫颈表观遗传学（SPEC）是一项对孕妇的前瞻性队列研究，年龄在 18 岁及以上。在这项分析中，我们纳入了在 2014 年 8 月 24 日之后入组且在 2019 年 1 月 20 日之前分娩的女性。由于女性可能多次入组，因此我们的队列包括了 774 名女性的 787 次妊娠。我们进行了潜在类别分析，以根据评估抑郁、感知压力、焦虑（与妊娠相关和一般）、生活应激事件、恢复力和社会支持（伴侣和朋友/家庭）的措施来识别在怀孕期间具有相似的不良心理社会因素模式的女性群体。在确定潜在类别后，我们使用对数二项式回归来比较类别之间早产的发生率。
结果
参与者的中位年龄为 33.2 岁（四分位距 30.3-36.3），大多数为非西班牙裔白人（56.9%）。我们确定了三种不良心理社会因素类别（因素少、因素中等和因素多）。共有 63 例（8.0%）妊娠导致早产。与因素少的参与者相比，因素中等（RR 1.23，95%CI 0.68，2.25）和因素多（RR 1.62，95%CI 0.73，3.62）的参与者早产的风险没有差异。
结论
我们确定了三种具有相似的不良心理社会因素模式的孕妇群体。我们没有观察到这些类别之间早产的风险存在差异。
Zotero 插件