Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St, Pittsburgh, PA, 15216, USA.
Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, 120 Lytton Ave. Suite 302, Pittsburgh, PA, 15213, USA.
Matern Child Health J. 2022 Feb;26(2):299-308. doi: 10.1007/s10995-021-03335-9. Epub 2022 Jan 7.
Syndemic theory posits that poor health outcomes co-occur and amplify each other in the context of harmful conditions that must be addressed simultaneously to improve health equity. This analysis identifies perinatal syndemic factors and examine how factors are related to STI in a sample of racially diverse young pregnant women.
Pregnant participants (n = 61) ages 14-21 from racially diverse backgrounds were recruited from a prenatal clinic for an ongoing longitudinal study between October 2019-February 2020. Participants completed a tablet survey assessing pregnancy intention, psychosocial factors (e.g., depression, stress, partner violence, pregnancy history) and consented to provide access to their medical records for STI and clinical urine samples screened for tobacco and cannabis use. Latent class analysis (LCA) was used to examine probabilities of co-occurring Syndemic indicators.
Half of the women were Black (52%) and primigravida (54%). Three classes were identified in the LCA, two of them reflecting syndemics related to STI from the medical record. The largest class was half Black (51%), with a high rate of STI (65%), and was characterized by factors including depressive symptoms (93%), stress (64%), and substance use (65% cannabis, 82% tobacco). Additionally, the class with the highest rates of STI (74%) also had higher rates of partner violence (48%), morning sickness (100%), and prenatal cannabis use (63%).
Findings indicate evidence of a syndemic related to increased STI. A longitudinal evaluation of syndemics in this cohort may inform appropriately tailored intervention strategies to promote perinatal health in racially diverse young pregnant populations.
综合征理论认为，在必须同时解决的有害条件下，不良健康结果会同时发生并相互放大，以提高健康公平性。本分析确定了围产期综合征因素，并研究了在种族多样化的年轻孕妇样本中，这些因素与性传播感染（STI）之间的关系。
2019 年 10 月至 2020 年 2 月期间，从一家产前诊所招募了来自不同种族背景、年龄在 14-21 岁之间的孕妇参与者（n=61），参与一项正在进行的纵向研究。参与者完成了一份平板电脑调查，评估怀孕意向、心理社会因素（例如抑郁、压力、伴侣暴力、怀孕史），并同意提供他们的医疗记录，以筛查 STI 和临床尿液样本，检测烟草和大麻使用情况。潜在类别分析（LCA）用于检查综合征指标同时出现的概率。
一半的女性为黑人（52%）和初产妇（54%）。LCA 确定了三个类别，其中两个反映了与医疗记录中 STI 相关的综合征。最大的类别是一半黑人（51%），STI 发生率很高（65%），其特征包括抑郁症状（93%）、压力（64%）和物质使用（65%大麻，82%烟草）。此外，STI 发生率最高的类别（74%）也有更高的伴侣暴力（48%）、晨吐（100%）和产前大麻使用（63%）。
研究结果表明，存在与 STI 增加相关的综合征证据。对该队列中综合征的纵向评估可能为促进种族多样化的年轻孕妇群体的围产期健康提供适当定制的干预策略。
