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检查具有不同产后症状类型的产后妇女的母体应激负荷。

Examination of Maternal Allostatic Load Among Postpartum Women With Distinct Postpartum Symptom Typologies.

机构信息

School of Nursing, Duke University, Durham, NC, USA.

School of Nursing, Columbia University, New York, NY, USA.

出版信息

Biol Res Nurs. 2024 Apr;26(2):279-292. doi: 10.1177/10998004231217680. Epub 2023 Nov 21.

Abstract

BACKGROUND

An increased allostatic load (cumulative physiologic wear and tear of the body) can lead to adverse health outcomes. Symptom experiences are known to influence allostatic load. Yet, the relationships between postpartum symptom typologies and maternal allostatic load remain unknown.

METHODS

We used Community Child Health Network data and included participants with allostatic load data at 6, 12, or 24 months postpartum. Bivariate and multivariate analyses were conducted to examine associations between postpartum symptom typologies and (a) overall allostatic load, (b) allostatic load subscales for body systems (neuroendocrine, cardiovascular, metabolic, and inflammatory), and (c) individual biomarkers within the subscale.

RESULTS

Overall allostatic load at 12 months postpartum was different by symptom typologies before ( = .042) and after adjusting for confounders ( = .029). Postpartum women in typology 5 ( had the highest adjusted overall allostatic load (M = 4.18, SE = .27). At 12 months, adjusted allostatic load for the cardiovascular subscale was higher in typologies 3 (, M = 1.78, SE = .13) and 5 (, M = 1.80, SE = .17). Within the cardiovascular subscale, those in typology 3 had higher adjusted odds for a clinically significant level of pulse rate (aOR = 2.01, CI = 1.22, 3.31).

CONCLUSION

Postpartum women who experienced high symptom severity across all symptoms (typology 5) at 6 months had higher overall allostatic load at 12 months postpartum. Typologies 3 and 5 had the highest symptom severity in sleep-related symptoms and higher cardiovascular subscale scores. Postpartum symptom management should target symptom burden in an effort to reduce allostatic load thereby improving postpartum women's health outcomes.

摘要

背景

身体的累积生理损耗(即身体的“应激负荷”增加)会导致不良的健康后果。症状体验已知会影响应激负荷。然而,产后症状类型与产妇应激负荷之间的关系尚不清楚。

方法

我们使用社区儿童健康网络数据,纳入了在产后 6、12 或 24 个月时具有应激负荷数据的参与者。进行了双变量和多变量分析,以检查产后症状类型与(a)整体应激负荷、(b)身体系统(神经内分泌、心血管、代谢和炎症)的应激负荷亚量表以及(c)亚量表内的各个生物标志物之间的关联。

结果

在产后 12 个月时,整体应激负荷因症状类型而异( =.042),且在调整混杂因素后仍有差异( =.029)。在 typology 5(的女性中,产后整体应激负荷最高(M = 4.18,SE =.27)。在 12 个月时,typologies 3(和 5(的女性中,心血管亚量表的调整后应激负荷更高(M = 1.78,SE =.13)和 5(M = 1.80,SE =.17)。在心血管亚量表中,typology 3 的女性脉搏率达到临床显著水平的调整后比值比(aOR)为 2.01(CI = 1.22,3.31)。

结论

在 6 个月时经历所有症状(typology 5)严重程度高的产后女性在产后 12 个月时的整体应激负荷更高。typologies 3 和 5 在睡眠相关症状中表现出最高的症状严重程度,且心血管亚量表得分更高。产后症状管理应针对症状负担,以降低应激负荷,从而改善产后女性的健康结果。

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