Growth Models of Maternal Smoking Behavior: Individual and Contextual Factors.
Growth Models of Maternal Smoking Behavior: Individual and Contextual Factors.
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DOI：
10.3109/10826084.2014.998234
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发表时间：
2015
影响因子：
2
通讯作者：
Liu W
中科院分区：
文献类型：
--
作者：
Mumford EA;Liu W
孕期持续吸烟，孕期减少或戒烟，产后开始或恢复吸烟，促使进一步研究了解这些行为模式和干预机会。我们调查了吸烟量的不同纵向模式，以确定这些模式是否在三个母亲年龄组中有所不同，以及个人和背景风险因素的影响是否因母亲年龄而不同。对于15-25岁、26-35岁和36岁以上的母亲，估计了不同的一般生长混合模型，允许在六个时间点对吸烟行为的顺序测量进行不同的经验模式，从先入为主到孩子进入幼儿园。我们为15-25岁的母亲确定了五个班，为26-35岁的母亲确定了四个班，为36岁以上的母亲确定了三个班。每个年龄组代表不吸烟者和持续重度吸烟者的类别。在光谱的这些两端之间，每个年龄组都表现出自己的吸烟类别，其特征是怀孕吸烟减少的程度和产后行为。在所有三个年龄组中，阶级成员可以通过个人的社会人口和行为特征来区分。同居的吸烟者预测了几乎所有年龄段的吸烟类别，而选定的社区特征预测了年轻(15-25岁)和年长(36岁以上)母亲的类别。为寻求怀孕的妇女和为产前或儿科护理的妇女提供的戒烟和戒烟服务的设计、时间和提供最好以个人特征为指导，特别是母亲的年龄、怀孕前饮酒和产后抑郁，但不同年龄的母亲应该进一步关注邻里特征。
Persistent maternal smoking during pregnancy, reduction or cessation during pregnancy, and smoking initiation or resumption postpartum impel further research to understand these behavioral patterns and opportunities for intervention. We investigated heterogeneous longitudinal patterns of smoking quantity to determine if these patterns vary across three maternal age groups, and whether the influence of individual and contextual risk factors varies by maternal age. Separate general growth mixture models were estimated for mothers ages 15–25, 26–35, and 36+, allowing different empirical patterns of an ordinal measure of smoking behavior at six time points, from preconception through child entry to kindergarten. We identify five classes for mothers ages 15–25, four classes for ages 26–35, and three classes for ages 36+. Each age group presents classes of nonsmokers and persistent heavy smokers. Intermediate to these ends of the spectrum, each age group exhibited its own smoking classes characterized by the extent of pregnancy smoking reductions and postpartum behavior. In all three age groups, class membership can be distinguished by individual sociodemographic and behavioral characteristics. Co-resident smokers predicted nearly all smoking classifications across age groups, and selected neighborhood characteristics predicted classification of younger (15–25) and older (36+) mothers. The design, timing, and delivery of smoking prevention and cessation services, for women seeking to become pregnant and for women presenting for prenatal or pediatric care, are best guided by individual characteristics, particularly maternal age, preconception alcohol consumption, and postpartum depression, but neighborhood characteristics merit further attention for mothers at different ages.