School of Nursing (Dr Cho) and Public Health (Dr Chien), University of Nevada, Las Vegas, and Duke University School of Nursing, Durham, North Carolina (Dr Holditch-Davis).
Adv Neonatal Care. 2022 Oct 1;22(5):E169-E181. doi: 10.1097/ANC.0000000000000997. Epub 2022 May 19.
Black mothers and their very low birth-weight infants in the United States have increased risk of adverse neonatal and maternal health outcomes compared with White mothers and infants. Disparities in adverse birth outcomes associated with sociodemographic factors are difficult to quantify and modify, limiting their usefulness in assessing intervention effects.
To test hypotheses that (1) the biological factors of maternal testosterone and cortisol are associated with sociodemographic factors and (2) both factors are associated with neonatal health and maternal mental health and healthy behaviors between birth and 40 weeks' gestational age.
We used a descriptive, longitudinal design. Eighty-eight mothers and very low birth-weight neonates were recruited from a tertiary medical center in the United States. Data on sociodemographic factors and neonatal health were collected from medical records. Maternal mental health and healthy behaviors were collected with questionnaires. Maternal salivary testosterone and cortisol levels were measured using enzyme immunoassays. Data were analyzed primarily using general linear and mixed models.
High testosterone and/or low cortisol levels were associated with younger age, less education, enrollment in a federal assistance program, being unmarried, being Black, poorer neonatal health, and delayed physical growth. Low cortisol level was related to higher levels of depressive symptoms. Black mothers had fewer healthy behaviors than White mothers.
Findings confirm that biological factors are associated with sociodemographic factors, and both are associated with neonatal health and maternal mental health and healthy behaviors. We propose using sociodemographic and biological factors concurrently to identify risk and develop and evaluate ante- and postpartum interventions.Video abstract available athttps://journals.na.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=59.
与白人母亲和婴儿相比，美国的黑人母亲及其极低出生体重的婴儿有更高的不良新生儿和产妇健康结局风险。与社会人口因素相关的不良分娩结局的差异很难量化和改变，这限制了它们在评估干预效果方面的作用。
检验以下假设：（1）母体睾酮和皮质醇的生物学因素与社会人口因素相关，（2）这两个因素均与新生儿健康和产妇在出生至 40 孕周期间的心理健康和健康行为相关。
我们采用描述性、纵向设计。从美国一家三级医疗中心招募了 88 名母亲及其极低出生体重的新生儿。从病历中收集社会人口因素和新生儿健康的数据。使用问卷调查收集产妇心理健康和健康行为的数据。使用酶免疫分析法测量母体唾液中的睾酮和皮质醇水平。主要使用一般线性和混合模型进行数据分析。
高睾酮和/或低皮质醇水平与年龄较小、受教育程度较低、参加联邦援助计划、未婚、黑人、新生儿健康较差以及体格生长延迟有关。低皮质醇水平与较高的抑郁症状水平相关。黑人母亲的健康行为比白人母亲少。
研究结果证实生物学因素与社会人口因素相关，两者均与新生儿健康和产妇心理健康及健康行为相关。我们建议同时使用社会人口和生物学因素来识别风险，并制定和评估产前和产后的干预措施。视频摘要可在以下网址查看：https://journals.na.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=59。
