Kaddoura Rima, Zankar Reine, Tamim Hani, El Bejjani Martine, Mahfoud Ziyad R, Salameh Pascale, Charafeddine Lama
Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon (Kaddoura).
Faculty of Medicine, American University of Beirut, Beirut, Lebanon (Zankar).
AJOG Glob Rep. 2025 Aug 7;5(3):100557. doi: 10.1016/j.xagr.2025.100557. eCollection 2025 Aug.
Preterm birth remains a leading cause of neonatal mortality globally and is worsened in crisis-affected countries like Lebanon. This study explored how social determinants of health relate to preterm birth and maternal postpartum outcomes, including quality of life (QoL), perceived stress, and social support.
to explore the impact of the social environment in polycrises context on preterm birth, the association between preterm birth and maternal postpartum QoL, perceived stress, and social support.
A prospective cohort study was conducted in three Lebanese hospitals from September 2021 to December 2023. A total of 116 mother-infant pairs (78 full-term, 38 preterm) were recruited. Data on social determinants, perceived stress (PSS-10), social support (MSPSS), and QoL (WHOQOL-BREF) were collected at delivery and 4 to 6 months postpartum. Analyses included tests, chi-square tests, and linear mixed models.
Mothers of preterm infants had significantly higher stress (PSS-10: 19.53 vs 15.29, =.011) and lower QoL scores across physical (39.16 vs 57.4, <.001), psychological (54.08 vs 66.91, <.001), and social (58.53 vs 69.56, =.007) domains at delivery. At 4 to 6 months postpartum, all mothers reported declines in social support (71.8 vs 67.3, =.003), social QoL (69.4 vs 61.4, =.005), and environmental QoL (70 vs 64.5, =.012).
This study highlights the impact of social support, stress, and QoL on preterm birth outcomes in a crisis-affected region. Mothers of preterm infants experienced higher stress and lower QoL at birth, suggesting the need for targeted interventions to support maternal mental health. Addressing these social determinants is needed for improving pregnancy outcomes, particularly in vulnerable populations facing multiple social and economic challenges.
早产仍是全球新生儿死亡的主要原因，在黎巴嫩等受危机影响的国家情况更为严峻。本研究探讨了健康的社会决定因素与早产及产妇产后结局之间的关系，包括生活质量（QoL）、感知压力和社会支持。
探讨多重危机背景下社会环境对早产的影响，以及早产与产妇产后生活质量、感知压力和社会支持之间的关联。
2021年9月至2023年12月在黎巴嫩的三家医院进行了一项前瞻性队列研究。共招募了116对母婴（78对足月产，38对早产）。在分娩时及产后4至6个月收集了关于社会决定因素、感知压力（PSS-10）、社会支持（MSPSS）和生活质量（WHOQOL-BREF）的数据。分析包括检验、卡方检验和线性混合模型。
早产婴儿的母亲在分娩时压力显著更高（PSS-10：19.53对15.29，P =.011），在身体（39.16对57.4，P<.001）、心理（54.08对66.91，P<.001）和社会（58.53对69.56，P =.007）领域的生活质量得分更低。在产后4至6个月，所有母亲的社会支持（71.8对67.3，P =.003）、社会生活质量（69.4对61.4，P =.005）和环境生活质量（70对64.5，P =.012）均有所下降。
本研究强调了社会支持、压力和生活质量对受危机影响地区早产结局的影响。早产婴儿的母亲在出生时经历了更高的压力和更低的生活质量，这表明需要有针对性的干预措施来支持产妇心理健康。改善妊娠结局需要解决这些社会决定因素，特别是在面临多重社会和经济挑战的弱势群体中。
