Department of Midwifery, Faculty of Nursing and Midwifery Islamic Azad University, Rasht branch, Rasht, Iran.
Pregnancy Health Center, Department of Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.
BMC Pregnancy Childbirth. 2022 May 28;22(1):445. doi: 10.1186/s12884-022-04784-y.
High-risk pregnancies require increased health and care resources to reduce the severe perinatal consequences. The adoption of a health-promoting lifestyle and social determinants is an important strategy for achieving the desired outcomes of pregnancy. This study aimed to compare intermediate determinants of social health in low and high-risk pregnant women.
This unmatched case-control study was performed with a ratio of 1: 2 and 300 pregnant women including 200 healthy and 100 pregnant women with gestational hypertension were included using the available sampling technique. Data were collected using socio-demographic and obstetrics, Health-promoting behaviors, Self-efficacy, Perceived stress, and Social support questionnaires by the self-report method.
There was no significant difference in the demographic characteristics between the two groups, except for the spouse's education status. The total score of health-promoting behaviors and social support in the healthy group was significantly higher than women with gestational hypertension. However, the perceived stress in women with gestational hypertension was significantly higher than in the healthy group. In the multivariate analysis, those women with high stress [AOR 1.13, 95% CI (1.08-1.18)] and whose Spouse's Educational status was low [AOR 4.94, 95% CI (1.54-15.81)] had higher odds of gestational hypertension than women who haven't respectively. The development of gestational hypertension was decreased by increasing the score of social support [AOR 0.96, 95% CI (0.93-0.98)]. The results showed that the two variables of social support (β=0.331) and self-efficacy (β=0.215) have the greatest impact on the score of health-promotion behaviors, respectively. Based on regression analysis, 21.2% of the health-promotion behaviors changes could be explained by three independent variables.
Women with gestational hypertension have unhealthier lifestyles. Having a high level of stress is a risk factor for gestational hypertension but Social support has a protective effect on it. Recognizing the risk factors of gestational hypertension could help the determination of high-risk cases and it is important to pay attention to women's psychosocial to create appropriate sources of social support and provide the necessary action to reduce stress.
高危妊娠需要增加健康和护理资源，以减少严重的围产期后果。采用促进健康的生活方式和社会决定因素是实现妊娠预期结果的重要策略。本研究旨在比较低危和高危孕妇的社会健康中间决定因素。
这是一项采用 1:2 比例的非匹配病例对照研究，共纳入 300 名孕妇，包括 200 名健康孕妇和 100 名妊娠高血压孕妇，采用现有抽样技术。使用社会人口学和产科、促进健康行为、自我效能、感知压力和社会支持问卷，通过自我报告的方法收集数据。
两组在人口统计学特征方面无显著差异，除配偶教育程度外。健康组的健康促进行为和社会支持总分明显高于妊娠高血压组。然而，妊娠高血压组的感知压力明显高于健康组。多变量分析显示，压力较高的女性[比值比（OR）1.13，95%置信区间（CI）（1.08-1.18）]和配偶教育程度较低的女性[比值比（OR）4.94，95%CI（1.54-15.81）]患妊娠高血压的可能性高于相应的女性。增加社会支持评分[比值比（OR）0.96，95%CI（0.93-0.98）]可降低妊娠高血压的发生风险。结果表明，社会支持（β=0.331）和自我效能（β=0.215）这两个变量对健康促进行为评分的影响最大。基于回归分析，三个独立变量可以解释健康促进行为变化的 21.2%。
妊娠高血压孕妇的生活方式更不健康。高水平的压力是妊娠高血压的危险因素，但社会支持对其具有保护作用。认识到妊娠高血压的危险因素有助于确定高危病例，并重视女性的社会心理，创造适当的社会支持来源，并采取必要的行动来减轻压力。
