Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
J Womens Health (Larchmt). 2022 Jun;31(6):878-886. doi: 10.1089/jwh.2021.0016. Epub 2021 Dec 17.
Maternal substance use and common mental disorders (CMDs) during or after pregnancy can lead to negative health outcomes among mothers and infants. We examined whether nativity (US-born versus foreign-born) and stress levels during pregnancy were associated with antenatal substance use and postnatal CMDs. We analyzed the Boston Birth Cohort, a racially diverse cohort recruited at birth with rolling enrollment since 1998. Information on antenatal substance use (tobacco and/or alcohol use) was obtained using an in-person postpartum questionnaire ( = 6,514). Information on postnatal CMDs (depression and/or anxiety) was obtained from medical records ( = 2,052). Nativity and stress during pregnancy were self-reported. We performed multivariate logistic regression to examine how nativity and stress levels were jointly associated with antenatal substance use and postnatal CMDs. We further investigated if blacks, Hispanics, and whites were differentially at risk. We found that US-born mothers were at higher risk of substance use and CMDs than their foreign-born counterparts. In analyses combining nativity and stress, being US-born with high stress was associated with increased odds of antenatal substance use (adjusted odds ratio [aOR] = 14.91, 95% confidence interval [CI]: 12.09-18.39) and postnatal CMDs (aOR = 4.09, 95% CI: 2.72-6.15) compared with foreign-born mothers with low stress. The results of the subanalyses limited to black and Hispanic women separately were similar; high stress alone was associated with fourfold increased odds of CMDs among foreign-born Hispanic mothers (aOR = 4.27, 95% CI: 1.96-9.33). Findings suggest that identifying and alleviating high stress among pregnant women may reduce their risk of antenatal substance use and postnatal CMDs.
孕产妇在孕期或产后使用物质和常见精神障碍（CMD）会导致母婴健康不良后果。我们研究了出生地点（美国出生或外国出生）和孕期压力水平是否与产前物质使用和产后 CMD 有关。我们分析了波士顿出生队列，这是一个种族多样化的队列，自 1998 年以来滚动招募，通过产后面对面问卷调查获取产前物质使用（烟草和/或酒精使用）信息（ = 6514）。产后 CMD（抑郁和/或焦虑）信息来自医疗记录（ = 2052）。出生地点和孕期压力是自我报告的。我们进行了多变量逻辑回归分析，以研究出生地点和压力水平如何共同与产前物质使用和产后 CMD 相关。我们进一步研究了黑人、西班牙裔和白人是否存在差异风险。我们发现，美国出生的母亲比外国出生的母亲更有可能使用物质和患有 CMD。在结合出生地点和压力的分析中，高压力的美国出生母亲与产前物质使用的几率增加有关（调整后的优势比[aOR] = 14.91，95%置信区间[CI]：12.09-18.39）和产后 CMD（aOR = 4.09，95% CI：2.72-6.15），与低压力的外国出生母亲相比。单独对黑人女性和西班牙裔女性进行的亚分析结果相似；仅高压力与外国出生的西班牙裔母亲患 CMD 的几率增加四倍有关（aOR = 4.27，95% CI：1.96-9.33）。研究结果表明，识别和缓解孕妇的高压力可能会降低其产前物质使用和产后 CMD 的风险。
