Ethnic disparity and exposure to supplements rather than adverse childhood experiences linked to preterm birth in Pakistani women

被引:11
作者
Shaikh, Kiran [1 ]
Premji, Shahirose Sadrudin [2 ]
Lalani, Sharifa [1 ]
Forcheh, Ntonghanwah [2 ]
Dosani, Aliyah [3 ]
Yim, Ilona S. [4 ]
Samia, Pauline [5 ]
Naugler, Christopher [6 ]
Letourneau, Nicole [7 ]
机构
[1] Aga Khan Univ, Karachi, Pakistan
[2] York Univ, Fac Hlth, Sch Nursing, Hlth Nursing & Environm Studies 313,4700 Keele St, Toronto, ON M3J 1P3, Canada
[3] Mt Royal Univ, Calgary, AB, Canada
[4] Univ Calif Irvine, Irvine, CA USA
[5] Aga Khan Univ Hosp, Nairobi, Kenya
[6] Alberta Publ Labs, Edmonton, AB, Canada
[7] Univ Calgary, Calgary, AB, Canada
基金
加拿大健康研究院;
关键词
Ethnic disparity; Adverse childhood experiences; Preterm birth; Supplements; Depression; Anxiety; PREGNANCY; DEPRESSION; METAANALYSIS; COUNTRIES; OUTCOMES; RISK; STRESS; GENDER; HEALTH; INCOME;
D O I
10.1016/j.jad.2020.01.180
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Adverse childhood experiences (ACEs) are associated with prenatal mental health and negative pregnancy outcomes in high income countries, but whether the same association exists in Pakistan, a low- to middle-income (LMI) country, remains unclear. Methods: Secondary data analyses of a prospective longitudinal cohort study examining biopsychosocial measures of 300 pregnant women at four sites in Karachi, Pakistan. A predictive multiple logistic regression model for preterm birth (PTB; i.e., <37 weeks' gestation) was developed from variables significantly (P < 0.05) or marginally (P < 0.10) associated with PTB in the bivariate analyses. Results: Of the 300 women, 263 (88%) returned for delivery and were included in the current analyses. The PTB rate was 11.1%. We found no association between ACE and PTB. Mother's education (P = 0.011), mother's ethnicity (P = 0.010), medications during pregnancy (P = 0.006), age at birth of first child or current age if primiparous (P = 0.049) and age at marriage (P = 0.091) emerged as significant in bivariate analyses. Mother's ethnicity and taking medications remained predictive of PTB in the multivariate model. Limitations: Findings are limited by the relatively small sample size which precludes direct testing for possible interactive effects. Conclusions: In sum, pathways to PTB for women in LMI countries may differ from those observed in high-income countries and may need to be modelled differently to include behavioural response to emotional distress and socio-cultural contexts.
引用
收藏
页码:49 / 56
页数:8
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