怀孕期间的压力会对产妇的心理健康造成严重的不良后果。产前压力的早期评估可以帮助确定治疗需求和适当的干预措施。健康的社会决定因素的差异会导致压力,但是,在健康框架的社会决定因素中,怀孕期间的压力构成尚不清楚。
■概述如何在美国暴露于三种主要社会压力源的孕妇中定义和测量产前压力:与食物有关的不安全,住房,和移民。
■我们纳入了所有关注粮食不安全背景下怀孕期间压力的研究,住房不稳定,移民,鉴于他们最近由于新冠肺炎大流行和持续的政治言论而关注政策,此外,他们在美国妇产科学院(ACOG)的健康筛查工具的社会决定因素的重要性。
■我们搜索了PubMed,Scopus,和WebofScience在2012年1月至2022年1月之间发表的文章。
■使用试点图表工具,我们从选择的文章中提取了相关的研究信息,并分析了与压力有关的内容。
■最初的搜索确定了1,023篇文章,其中24人符合我们的纳入标准。没有一项研究定义产前压力,只有一个人使用了产前窘迫问卷,产前压力特定的工具来测量它。感知压力量表是七项研究中最常用的工具。15项研究测量了25种替代暴露,研究人员认为这些暴露与压力有关,15项研究中有4项没有解释测量与压力之间的关联.
■我们的研究结果表明,在健康的社会决定因素的背景下,如何定义和测量产前压力存在根本的不一致。限制不同研究结果的比较和有效干预措施的潜在发展,以促进更好的孕产妇心理健康。
Stress during pregnancy can lead to significant adverse outcomes for maternal mental health. Early evaluation of prenatal stress can help identify treatment needs and appropriate interventions. Disparities in the social determinants of health can contribute to stress, but what constitutes stress during pregnancy within the social determinants of health framework is poorly understood.
To scope how prenatal stress is defined and measured among pregnant people exposed to three prominent social stressors in the United States: insecurity pertaining to food, housing, and immigration.
We included all studies that focused on stress during pregnancy in the context of food insecurity, housing instability, and immigration, given their recent policy focus due to the COVID-19 pandemic and ongoing political discourse, in addition to their importance in American College of Obstetricians and Gynecologists (ACOG\'s) social determinants of health screening tool.
We searched PubMed, Scopus, and Web of Science for articles published between January 2012 and January 2022.
Using a piloted charting tool, we extracted relevant study information from the selected articles and analyzed the content pertaining to stress.
An initial search identified 1,023 articles, of which 24 met our inclusion criteria. None of the studies defined prenatal stress, and only one used the Prenatal Distress Questionnaire, a prenatal stress-specific tool to measure it. The Perceived Stress Scale was the most common instrument used in seven studies. Fifteen studies measured over 25 alternative exposures that researchers theorized were associated with stress, and 4 of the 15 studies did not explain the association between the measure and stress.
Our findings demonstrate a fundamental inconsistency in how prenatal stress is defined and measured in the context of social determinants of health, limiting the comparison of results across studies and the potential development of effective interventions to promote better maternal mental health.