Sociodemographic and Biological Factors of Health Disparities of Mothers and Their Very Low Birth-Weight Infants.
Sociodemographic and Biological Factors of Health Disparities of Mothers and Their Very Low Birth-Weight Infants.
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DOI：
10.1097/anc.0000000000000997
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发表时间：
2022-10-01
影响因子：
1.7
通讯作者：
Holditch-Davis, Diane
中科院分区：
文献类型：
--
作者：
Cho, June;Chien, Lung-Chang;Holditch-Davis, Diane
关键词：
与白人母亲和婴儿相比，美国黑人母亲及其极低出生体重婴儿的新生儿和产妇健康结局不良的风险增加。与社会人口学因素相关的不良生育结果的差异很难量化和修改，限制了它们在评估干预效果方面的有效性。检验以下假设：(1)母体睾酮和皮质醇的生物学因素与社会人口学因素有关；(2)这两个因素与新生儿健康、母体心理健康和出生至40周胎龄之间的健康行为有关。我们使用了描述性的纵向设计。88名母亲和极低出生体重的新生儿是从美国的一家三级医疗中心招募的。有关社会人口学因素和新生儿健康的数据从医疗记录中收集。采用问卷调查法收集产妇心理健康状况和健康行为。用酶免疫法测定母体唾液睾酮和皮质醇水平。数据主要使用一般线性模型和混合模型进行分析。高睾酮和/或低皮质醇水平与年龄较小、受教育程度较低、参加联邦援助计划、未婚、黑人、新生儿健康状况较差和身体发育迟缓有关。低皮质醇水平与较高水平的抑郁症状有关。黑人母亲的健康行为比白人母亲少。研究结果证实，生物因素与社会人口学因素有关，两者都与新生儿健康、母亲心理健康和健康行为有关。我们建议同时使用社会人口学和生物学因素来识别风险，并制定和评估产前和产后干预措施。视频摘要可在https://journals.na.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=59上查看
Black mothers and their very low birth-weight infants in the United States have increased risk of adverse neonatal and maternal health outcomes compared with White mothers and infants. Disparities in adverse birth outcomes associated with sociodemographic factors are difficult to quantify and modify, limiting their usefulness in assessing intervention effects. To test hypotheses that (1) the biological factors of maternal testosterone and cortisol are associated with sociodemographic factors and (2) both factors are associated with neonatal health and maternal mental health and healthy behaviors between birth and 40 weeks' gestational age. We used a descriptive, longitudinal design. Eighty-eight mothers and very low birth-weight neonates were recruited from a tertiary medical center in the United States. Data on sociodemographic factors and neonatal health were collected from medical records. Maternal mental health and healthy behaviors were collected with questionnaires. Maternal salivary testosterone and cortisol levels were measured using enzyme immunoassays. Data were analyzed primarily using general linear and mixed models. High testosterone and/or low cortisol levels were associated with younger age, less education, enrollment in a federal assistance program, being unmarried, being Black, poorer neonatal health, and delayed physical growth. Low cortisol level was related to higher levels of depressive symptoms. Black mothers had fewer healthy behaviors than White mothers. Findings confirm that biological factors are associated with sociodemographic factors, and both are associated with neonatal health and maternal mental health and healthy behaviors. We propose using sociodemographic and biological factors concurrently to identify risk and develop and evaluate ante- and postpartum interventions. Video abstract available at https://journals.na.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=59