School of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand; BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Department of Psychology, McGill University, Montreal, QC, Canada.
Sex Reprod Healthc. 2024 Jun;40:100981. doi: 10.1016/j.srhc.2024.100981. Epub 2024 May 6.
The present study aimed to understand, relative to standard care, whether continuity of care models (private midwifery, continuity of care with a private doctor, continuity of care with a public midwife), and women's experience of maternity care provision, during the perinatal period buffered the association between prenatal maternal stress (PNMS) and infant birth outcomes (gestational age [GA], birth weight [BW] and birth weight for gestational age [BW for GA]).
2207 women who were pregnant in Australia while COVID-19 restrictions were in place reported on their COVID-19 related objective hardship and subjective distress during pregnancy and provided information on their model of maternity care. Infant birth outcomes (BW, GA) were reported on at 2-months postpartum.
Multiple linear regressions showed no relationship between PNMS and infant BW, GA or BW for GA, and neither experienced continuity of care, nor model of maternity care moderated this relationship. However, compared with all other models of care, women enrolled in private midwifery care reported the highest levels of experienced continuity of care and birthed infants at higher GA. BW and BW for GA were higher in private midwifery care, relative to standard care.
Enrollment in continuous models of perinatal care may be a better predictor of infant birth outcomes than degree of PNMS exposure. These results highlight the possibility that increased, continuous support to women during pregnancy may play an important role in ensuring positive infant birth outcomes during future pandemics.
本研究旨在了解，与标准护理相比，围产期护理模式（私人助产士、与私人医生的连续护理、与公共助产士的连续护理）以及女性在围产期期间获得的产妇护理体验是否缓冲了产前产妇压力（PNMS）与婴儿出生结局（胎龄[GA]、出生体重[BW]和胎龄体重比[BW for GA]）之间的关联。
2207 名在澳大利亚怀孕的女性在 COVID-19 限制期间报告了她们在怀孕期间的 COVID-19 相关客观困难和主观困扰，并提供了她们的产妇护理模式信息。婴儿的出生结局（BW、GA）在产后 2 个月报告。
多元线性回归显示，PNMS 与婴儿 BW、GA 或 BW for GA 之间没有关系，也没有体验到连续性护理，也没有产妇护理模式调节这种关系。然而，与所有其他护理模式相比，参加私人助产士护理的女性报告了更高水平的体验连续性护理，并在更高的 GA 时分娩。与标准护理相比，私人助产士护理的 BW 和 BW for GA 更高。
参加围产期连续护理模式可能比 PNMS 暴露程度更好地预测婴儿出生结局。这些结果强调了在未来大流行期间，增加对女性的持续支持可能在确保婴儿出生结局方面发挥重要作用的可能性。
