Nordgren Inga, Duncan Robert J, Moding Kameron J, Posada German E
Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, United States.
Department of Human Development and Family Science, Colorado State University, Boulder, Colorado, United States.
Matern Child Health J. 2025 Jul 7. doi: 10.1007/s10995-025-04128-0.
Prenatal care provides an opportunity for the promotion of healthy parent and neonatal outcomes, but there are gaps in understanding the consequences and antecedents of prenatal care experiences during pregnancy. The objective of the current study was to provide insight into the mediational processes of sociodemographic and pregnancy characteristics on neonatal health and postpartum maternal wellbeing outcomes through prenatal care experiences. Data were analyzed from the publicly available Listening to Mothers III dataset comprised of 2,400 online-survey participants (ages 18-45) who gave birth to singleton infants in hospitals between July 2011 and June 2012 in the U.S. Primary analyses were conducted using two separate path analysis models examining maternal characteristics (i.e., sociodemographic and pregnancy factors) and the mediation of prenatal care experiences (i.e., responsive provider behavior, week of first prenatal visit, and attendance in group prenatal care) on infant health (i.e., preterm, low birthweight, NICU stays) and postpartum maternal wellbeing (i.e., social support, depression, confidence). The perceived need for treatment of depression and smoking during pregnancy resulted in 0.15 and 0.20 larger proportions of infants admitted into the NICU, respectively. Women who reported responsive provider behavior indicated higher social support (b = 0.29, p <.001), less depressive symptomology (b = -0.20, p <.001), and felt more confident (b = 0.07, p =.005). While maternal characteristics were related to neonatal health, the interpersonal experiences during prenatal care related to postpartum maternal wellbeing, indicating a need for providers to bolster their responsiveness to women during prenatal visits.
产前护理为促进健康的母婴结局提供了机会，但在理解孕期产前护理经历的后果及影响因素方面仍存在差距。本研究的目的是通过产前护理经历，深入了解社会人口学和妊娠特征对新生儿健康及产后母亲幸福感结局的中介过程。数据来自公开可用的“倾听母亲III”数据集，该数据集由2400名在线调查参与者（年龄在18 - 45岁之间）组成，他们于2011年7月至2012年6月在美国的医院分娩单胎婴儿。主要分析使用两个单独的路径分析模型进行，分别检验母亲特征（即社会人口学和妊娠因素）以及产前护理经历（即医护人员的响应行为、首次产前检查的孕周和参加产前护理小组情况）对婴儿健康（即早产、低出生体重、入住新生儿重症监护病房）和产后母亲幸福感（即社会支持、抑郁、自信）的中介作用。孕期对抑郁症治疗和吸烟的感知需求分别导致入住新生儿重症监护病房的婴儿比例高出0.15和0.20。报告医护人员有响应行为的女性表示有更高的社会支持（b = 0.29，p <.001）、更少的抑郁症状（b = -0.20，p <.001）且感觉更自信（b = 0.07，p =.005）。虽然母亲特征与新生儿健康有关，但产前护理期间的人际经历与产后母亲幸福感有关，这表明医护人员在产前检查期间需要增强对女性的响应能力。
