Syndemic of Lifetime Mental Illness, Substance Use Disorders, and Trauma and Their Association With Adverse Perinatal Outcomes
| العنوان: | Syndemic of Lifetime Mental Illness, Substance Use Disorders, and Trauma and Their Association With Adverse Perinatal Outcomes |
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| المؤلفون: | Lynn R. McDonald, Maybel Wahab, Amy S.D. Lee, Caiyun Liao, Jenell S. Coleman, Denis G. Antoine |
| المصدر: | Journal of Interpersonal Violence. 35:476-495 |
| بيانات النشر: | SAGE Publications, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Substance-Related Disorders, Perinatal Death, Poison control, Suicide prevention, Young Adult, Syndemic, Pregnancy, Intensive Care Units, Neonatal, Injury prevention, medicine, Humans, 0501 psychology and cognitive sciences, Psychiatry, Applied Psychology, Retrospective Studies, business.industry, Mental Disorders, Sex Offenses, 050901 criminology, 05 social sciences, Pregnancy Outcome, Human factors and ergonomics, Infant, Low Birth Weight, medicine.disease, Mental illness, Infant mortality, Race Factors, Substance abuse, Clinical Psychology, Physical Abuse, Baltimore, Premature Birth, Female, Pregnant Women, 0509 other social sciences, business, 050104 developmental & child psychology, Clinical psychology |
| الوصف: | Adverse perinatal outcomes are a significant contributor to neonatal and infant deaths. Mental illness, substance use disorders, and interpersonal trauma are often prevalent within obstetrical populations. Previous literature has documented the individual associations between these psychosocial factors and adverse perinatal outcomes. The co-occurrence of these three psychosocial factors might represent a syndemic among pregnant women, although they have not been described as such in the literature. Analysis of the interrelatedness and aggregate effect of these factors may allow for a more effective screening process that may reduce adverse perinatal outcomes. The objective of this article is to examine whether psychosocial factors (mental illness, substance use disorders, and interpersonal trauma) were independently and synergistically associated with adverse perinatal outcomes. This is a retrospective cohort study of 1,656 pregnant women at a single institution. Perinatal outcome and psychosocial data were abstracted from each participant’s electronic medical record. Univariate and bivariate analyses, and multiple logistic regression were performed. Mean age was 27.5 ( SD = 6.2) years. The majority was Black (60.6%) and single (58%). Psychosocial factors were reported in 35% of women. The incidence of adverse perinatal outcomes increased with greater number of psychosocial factors: 21.2% if no psychosocial factor, 27.0% if one psychosocial factor, 27.4% if two, and 35.3% if all three (for trend, p = .01). Women who reported all three psychosocial factors had twice the odds of adverse perinatal outcomes (adjusted odds ratio = 2.04, 95% confidence interval = [1.09, 3.81], p = .03) compared with those who reported none. Our data suggest there is a synergistic relationship between the psychosocial factors that is associated with increased adverse perinatal outcomes. A validated screening tool is needed to stratify patient’s risk of adverse perinatal outcomes based on psychosocial factors. Such screening could lead to tailored interventions that could decrease adverse perinatal outcomes. |
| تدمد: | 1552-6518 0886-2605 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c6613d1311686e22cf1de0c5af3185dc https://doi.org/10.1177/0886260516685708 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....c6613d1311686e22cf1de0c5af3185dc |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15526518 08862605 |
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