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SHS-Related Pediatric Sick Visits are Linked to Maternal Depressive Symptoms among Low-Income African American Smokers: An Opportunity for Intervention in Pediatrics

机译:相关的儿科病房与低收入非洲裔美国吸烟者之间的母体抑郁症状有关:有机会干预儿科

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摘要

Maternal smoking and depressive symptoms are independently linked to poor child health outcomes. However, little is known about factors that may predict maternal depressive symptoms among low-income, African American maternal smokers - an understudied population with children known to have increased morbidity and mortality risks. The objective of this study was to test the hypothesis that secondhand smoke exposure (SHSe)-related pediatric sick visits are associated with significant maternal depressive symptoms among low-income, African American maternal smokers in the context of other depression-related factors. Prior to randomization in a behavioral counseling trial to reduce child SHSe, 307 maternal smokers in Philadelphia completed the CES-D and questionnaires measuring stressful events, nicotine dependence, social support, child health and demographics. CES-D was dichotomized at the clinical cutoff to differentiate mothers with significant vs. low depressive symptoms. Results from direct entry logistic regression demonstrated that maternal smokers reporting more than one SHSe-related sick visit (OR 1.38, p<.001), greater perceived life stress (OR 1.05, p<.001) and less social support (OR 0.82, p<.001) within the last 3 months were more likely to report significant depressive symptoms than mothers with fewer clinic visits, less stress, and greater social support. These results suggest opportunities for future hypothesis-driven evaluation, and exploration of intervention strategies in pediatric primary care. Maternal depression, smoking and child illness may present as a reciprocally-determined phenomenon that points to the potential utility of treating one chronic maternal condition to facilitate change in the other chronic condition, regardless of which primary presenting problem is addressed. Future longitudinal research could attempt to confirm this hypothesis.
机译:产妇吸烟和抑郁症状与不良的儿童健康状况独立相关。但是,对于可能预测低收入,非洲裔美国孕妇吸烟者中的孕妇抑郁症状的因素知之甚少,这是一个被研究不足的人口,其儿童的发病率和死亡率风险增加。这项研究的目的是检验以下假设:在其他与抑郁症相关的因素中,二手烟暴露(S​​HSe)相关的儿科病访视与低收入,非洲裔美国孕妇吸烟者中的明显的母亲抑郁症状相关。在减少儿童SHSe行为咨询试验的随机分组之前,费城的307名孕产妇吸烟者完成了CES-D和问卷调查,这些问卷测量了压力事件,尼古丁依赖,社会支持,儿童健康和人口统计数据。 CES-D在临床终止时被分为两部分,以区分具有明显抑郁症状和低抑郁症状的母亲。直接进入逻辑回归分析的结果表明,吸烟者报告了一次以上与SHSe相关的病访(OR 1.38,p <.001),更大的感知生活压力(OR 1.05,p <.001)和较少的社会支持(OR 0.82, (p <.001)在过去3个月内比起门诊较少,压力较小和社会支持更大的母亲更有可能报告出明显的抑郁症状。这些结果为未来的假设驱动的评估和儿科初级保健中的干预策略探索提供了机会。孕产妇抑郁,吸烟和儿童疾病可能是相互决定的现象,表明治疗一种慢性孕产妇疾病可能有助于促进另一种慢性病的改变,而无论解决了哪个主要表现问题。未来的纵向研究可能会试图证实这一假设。

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