Posttraumatic Symptom Reporting and Reported Cigarette Smoking During Pregnancy.
Posttraumatic Symptom Reporting and Reported Cigarette Smoking During Pregnancy.
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创伤后症状报告和怀孕期间吸烟的报告。
DOI：
10.1089/jwh.2016.5928
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Epperson,CNeill
中科院分区：
文献类型：
--
作者：
Kornfield,SaraL;Moseley,Marian;Appleby,Dina;McMickens,CourtneyL;Sammel,MaryD;Epperson,CNeill
简介：众所周知，患有创伤后应激障碍 (PTSD) 的个体对尼古丁依赖的患病率有所增加。然而，关于怀孕期间吸烟率与孕前创伤暴露史和怀孕期间活动性 PTSD 症状之间关系的研究有限。产前吸烟会对母亲和婴儿造成许多负面后果。考虑到孕产妇和胎儿的风险，确定怀孕期间继续吸烟的预测因素至关重要。方法：来自城市围产期诊所的孕妇使用改良的创伤性生活事件问卷（TLEQ）完成了创伤史的匿名调查，使用创伤后应激障碍症状检查表 - 平民版（PCL-C）完成了创伤后应激障碍症状以及当前和过去吸烟行为的匿名调查。确认怀孕后每天吸烟任意数量的人被视为“怀孕吸烟者”。 结果：在完成调查的 218 名女性中，有 34 名（15.6%）报告在确认怀孕后吸烟。在未经调整的模型中，导致恐惧、无助或恐怖 (FHH) 的创伤暴露，以及当前 PTSD 症状的严重程度和可能的 PTSD 诊断显示出作为怀孕期间吸烟的预测因素的统计显着性。仅调整年龄后，创伤后应激障碍症状仍然与怀孕期间吸烟存在显着相关性。当每天至少吸五支烟的历史被添加到我们的模型中时，没有任何关联仍然显着。结论：这些发现强调了对过去创伤性暴露的行为反应在影响怀孕前吸烟行为方面的重要性。鉴于此类行为会增加怀孕期间继续吸烟的风险，在孕前护理中采取基于创伤的戒烟方法可能最终会降低怀孕期间吸烟的可能性，因此需要进一步研究。
Introduction:Increased prevalence of nicotine dependence among individuals suffering from posttraumatic stress disorder (PTSD) is well established. However, there are limited studies on the prevalence of smoking during pregnancy in relation to prepregnancy history of trauma exposures and active PTSD symptoms during pregnancy. Prenatal smoking has been implicated in a host of negative outcomes for mother and baby. Given maternal and fetal risk, it is critical to define predictors of continued cigarette smoking during pregnancy.Methods:Pregnant women from an urban perinatal clinic completed an anonymous survey of trauma history using a modified Traumatic Life Events Questionnaire (TLEQ), PTSD symptoms using the PTSD Symptom Checklist—Civilian Version (PCL-C) and current and past smoking behavior. Those who smoked any number of cigarettes per day after pregnancy confirmation were considered to be “pregnant smokers.”Results:Of 218 women who completed the survey, 34 (15.6%) reported smoking cigarettes after confirmation of pregnancy. In unadjusted models, trauma exposure that resulted in fear, helplessness, or horror (FHH), as well as current PTSD symptom severity and probable PTSD diagnosis showed statistical significance as predictors of smoking during pregnancy. After adjusting for age only, PTSD symptoms retained their significant association with smoking during pregnancy. When history of smoking at least five cigarettes per day was added to our models, none of the associations remained significant.Conclusions:These findings emphasize the importance of the behavioral response to past traumatic exposures in influencing cigarette smoking behavior before pregnancy. Given such behaviors enhance risk for continued tobacco use during pregnancy, a trauma-informed approach to smoking cessation in preconception care may ultimately reduce the likelihood of smoking during pregnancy and requires further study.
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