孕期应激性生活事件与电子烟使用。

Stressful life events and electronic cigarette use during pregnancy.

机构信息

Department of Criminology & Criminal Justice, University of Texas at San Antonio, San Antonio, TX, USA.

Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

出版信息

Soc Sci Med. 2021 May;276:113845. doi: 10.1016/j.socscimed.2021.113845. Epub 2021 Mar 16.

DOI:10.1016/j.socscimed.2021.113845

PMID:33761384

Abstract

RATIONALE

Smoking during pregnancy poses a significant health risk for infant well-being. Prior research has linked experiencing stressful life events (SLEs) during pregnancy to prenatal smoking. However, extant research has not assessed whether SLEs experienced during pregnancy are a risk factor for prenatal electronic cigarette use.

OBJECTIVE

This study investigates the association between SLEs and electronic cigarette use during the third trimester of pregnancy.

METHODS

We employ data on 70,626 recent mothers from the 2016-2018 Pregnancy Risk Assessment Monitoring System. Logistic and multinomial logistic regression models were used to examine the association between SLEs and electronic cigarette use during the third-trimester of pregnancy.

RESULTS

The prevalence of electronic cigarette use increased alongside an accumulating history of SLEs (0 SLEs = 0.4%; 1-2 SLEs = 0.9%; 3-5 SLEs = 1.9%; 6+ SLEs = 5.0%). Logistic regression models found 6 or more SLEs were associated with 4.7 times higher odds of electronic cigarette use relative to 0 SLEs after adjusting for demographic and socioeconomic characteristics (AOR = 4.705, 95% CI = 2.960, 7.479). Study findings also showed that women who experienced greater levels of SLEs had a higher prevalence of using any nicotine products (i.e., exclusive electronic cigarette user, exclusive cigarette user, dual user), relative to being a non-smoker. Findings from multinomial logistic regression models revealed that a higher number of SLEs was associated with an increased relative risk of all smoking outcomes. Still, these associations were particularly pronounced in the case of exclusive electronic cigarette user (ARR = 8.485, 95% CI = 4.900, 14.692) and dual-use (ARR = 8.348, 95% CI = 4.113, 16.945) when participants experienced 6 or more SLEs (relative to 0 SLEs).

CONCLUSIONS

Considering the potentially harmful ramifications of electronic cigarette use during pregnancy there is a need for interventions that reduce stressful experiences and decrease smoking during pregnancy.

摘要

背景

怀孕期间吸烟会对婴儿健康造成重大风险。先前的研究已经将怀孕期间经历的应激性生活事件（SLEs）与产前吸烟联系起来。然而，现有的研究并未评估怀孕期间经历的 SLE 是否是产前使用电子烟的危险因素。

目的

本研究调查了 SLE 与妊娠晚期电子烟使用之间的关联。

方法

我们使用了 2016-2018 年妊娠风险评估监测系统中 70626 名近期母亲的数据。使用逻辑回归和多项逻辑回归模型来检查 SLE 与妊娠晚期使用电子烟之间的关联。

结果

电子烟使用率随着 SLE 病史的积累而增加（0 SLEs = 0.4%；1-2 SLEs = 0.9%；3-5 SLEs = 1.9%；6+ SLEs = 5.0%）。调整人口统计学和社会经济特征后，逻辑回归模型发现，与 0 SLEs 相比，经历 6 次或更多 SLE 与电子烟使用的可能性高 4.7 倍（OR = 4.705，95%CI = 2.960，7.479）。研究结果还表明，经历更多 SLE 的女性使用任何尼古丁产品（即电子烟专用用户、香烟专用用户、双重用户）的比例相对更高，而非非吸烟者。多项逻辑回归模型的结果表明，更多的 SLE 与所有吸烟结果的相对风险增加有关。然而，在电子烟专用用户（ARR = 8.485，95%CI = 4.900，14.692）和双重用户（ARR = 8.348，95%CI = 4.113，16.945）的情况下，这些关联更为明显，当参与者经历 6 次或更多 SLE 时（与 0 SLEs 相比）。