Psychosocial stress and its relation to maternal and infant outcomes among women with disabilities

残疾妇女的心理社会压力及其与母婴结局的关系

• 批准号: 10393139
• 负责人: JEANNE L ALHUSEN
• 金额: $ 23.03万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10393139
• 关键词: Address; Admission activity; Affect; Attitude; Caring; Data; Data Analyses; Development; Disabled Persons; Evaluation; Evidence based intervention; Female of child bearing age; Focus Groups; Foundations; Future; Goals; Health Personnel; Health Promotion; Healthcare; Individual; Infant; Intervention; Interview; Knowledge; Low Birth Weight Infant; Mental Depression; Methods; Mood Disorders; Morbidity - disease rate; Mothers; Neonatal Intensive Care Units; Perinatal; Perinatal Care; Phase; Policies; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Prenatal care; Psychosocial Stress; Recommendation; Research; Risk; Risk Factors; Role; Testing; Underserved Population; Woman; Women' s Group; adverse birth outcomes; clinical practice; depressive symptoms; design; disability; disparity reduction; ethnic diversity; experience; improved; infant outcome; intimate partner violence; maternal outcome; mortality; perinatal health; perinatal outcomes; perinatal period; population based; pregnant; preventive intervention; protective factors; racial diversity; symptomatology; violence prevention; women with disabilities

Women with disabilities are increasingly becoming pregnant, and may be as likely to become pregnant as women without disabilities. Growing research suggests pregnancy in women with disability is associated with an increased risk for adverse perinatal outcomes. Although a few studies have examined disability-related disparities in adverse birth outcomes, finding increased risk of low birthweight, preterm birth, and neonatal intensive care unit admission, the mechanisms for these associations are not well understood. One plausible mechanism is the increased risk of psychosocial stress experienced by women with disabilities in the perinatal period. Women with disabilities are at heightened risk for intimate partner violence (IPV) and mood disorders, yet the extent to which these risks affect pregnancy outcomes has not been studied. A more comprehensive understanding of psychosocial stress, namely IPV and depressive symptomatology, and its relation to adverse birth outcomes is critically needed to reduce morbidity and mortality rates among disabled mothers and their infants, reduce disparities in perinatal care between women with and without disabilities, inform the design of effective evidence-based interventions for this understudied and underserved population of women, and generate recommendations for clinical practice and policy change. To address this gap, we propose to systematically examine the association between psychosocial stress and adverse birth outcomes. Using a mixed method approach, we will: 1) examine the association between psychosocial stress (i.e., perinatal IPV and depressive symptomatology) and adverse birth outcomes (i.e., low birthweight, preterm birth) by analyzing data from PRAMS Phase 9 across women with and without disabilities; 2) explore the experiences and barriers to comprehensive perinatal care through individual interviews with ethnically and racially diverse pregnant and new mothers with diverse disabilities; and 3) explore facilitators and barriers (e.g., disability-related knowledge, attitudes, and pregnancy care experience) to the provision of comprehensive perinatal health care to women with disabilities through focus groups and individual in-depth interviews with health care providers who care for pregnant women with disabilities with the goal of improving perinatal care for this underserved group of women. This research will also serve as the foundation for the development and evaluation of future prevention interventions, including our own team’s planned submission to adapt, tailor, and test existing successful health promotion interventions to prevent violence and its related sequelae among women with disability, thereby optimizing pregnancy outcomes for women of childbearing age living with disability.

残疾妇女越来越怀孕，可能会怀孕 没有残疾的妇女。越来越多的研究表明，残疾女性的怀孕与 不良围产期结果的风险增加。尽管有一些研究检查了与残疾有关的研究 提前出生结果的差异，发现低出生体重，早产和新生儿的风险增加 重症监护病房的接纳，这些关联的机制尚不清楚。一个合理 机制是围产期残疾妇女遇到的心理压力的风险增加 时期。患有疾病的妇女对亲密伴侣暴力（IPV）和情绪障碍的风险更高， 然而，这些风险影响妊娠结局的程度尚未研究。更全面 了解心理压力，即IPV和抑郁症状，及其与逆境的关系 至关重要的生日成果需要降低残疾母亲及其的发病率和死亡率 婴儿，减少有和无差异的妇女之间的围产期护理差异，告知设计 对这种理解和服务不足的妇女人群的有效基于证据的干预措施，以及 为临床实践和政策变化产生建议。为了解决这个差距，我们建议 系统地检查社会心理压力与不良出生结果之间的关联。使用 混合方法方法，我们将：1）检查社会心理压力之间的关联（即围产期IPV 通过分析 来自有害妇女的第9阶段的婴儿车的数据； 2）探索经验和障碍 通过对种族和大致多样化的孕妇进行个人访谈，以全面的围产期护理和 有潜水残疾人的新母亲； 3）探索促进者和障碍（例如，与残疾相关的知识， 态度和怀孕护理经验）为妇女提供全面的围产期医疗保健 通过焦点小组和对关心的医疗保健提供者进行的个人深入访谈而与疾病进行疾病 残疾孕妇的目的是改善这一服务不足的人群的围产期护理 女性。这项研究还将成为开发和评估未来预防的基础 干预措施，包括我们自己的团队计划提交的提交，以适应，裁缝和测试现有的成功健康 促进干预措施以防止残疾妇女中的暴力及其相关后遗症 优化患有残疾儿童的妇女的怀孕结局。