Maternal Postpartum Symptom Profiles and Associated Social Determinants of Health

母亲产后症状概况和相关的健康社会决定因素

• 批准号: 10534820
• 负责人: Jihye Kim Scroggins
• 金额: $ 3.02万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10534820
• 关键词: Address; Adult; Anxiety; Attention; Birth; Black race; Cardiovascular system; Child Health; Cohort Studies; Communities; Complex; Cross-Sectional Studies; Data; Food; Foundations; Funding; Future; Goals; Health; Hispanic; Individual; Intervention; Knowledge; Life Cycle Stages; Link; Long-Term Depression; Low income; Maternal Health; Maternal Mortality; Mental Depression; Mentorship; Metabolic; Methodology; Methods; Mothers; National Institute of Nursing Research; Neighborhoods; Nurses; Obesity; Outcome; Personal Satisfaction; Persons; Physiological; Postpartum Depression; Postpartum Period; Prevention; Quality of life; Research; Resources; Risk; Role; Sampling; Scientist; Severities; Site; Sleep; Sleep disturbances; Strategic Planning; Stress; Subgroup; Symptoms; Time; Training; United States; Weight; Weight Gain; Woman; allostatic load; associated symptom; base; cardiovascular disorder risk; cardiovascular risk factor; ethnic diversity; experience; health disparity; high risk; improved; insight; interest; maternal morbidity; novel; patient subsets; person centered; personalized intervention; post-traumatic stress; postpartum health; postpartum weight; programs; racial and ethnic; racial disparity; reduce symptoms; response; social; social health determinants; symptom cluster; symptom management; symptom science; therapy development

ABSTRACT. Annually 3.8 million women give birth in the United States (US). Many postpartum mothers experience an array of postpartum symptoms, such as sleep disturbance and postpartum depression, which have been linked to postpartum weight retention and long-term weight gain, increasing the cardiovascular risks over the life course. Thus, postpartum symptoms and their effects impact mothers’ overall health and quality of life. Postpartum symptoms often co-occur and are correlated to each other, which is referred to as symptom clusters. Compared to an individually manifested symptom, symptom clusters are more difficult to manage and contribute to worse health outcomes. Previous research has focused on either individual symptom severity or occurrence, which limits our understanding of how postpartum symptom clusters manifest and impact health. In addition, a lack of racial-ethnic diversity in prior research creates a critical gap in understanding the racial disparities in US maternal health. This study will use data from a federally-funded study, Community Child Health Network, and will include 940 Black and 408 Hispanic mothers (76% of the sample). The aims are to: Aim 1. Identify subgroups of mothers with different symptom profiles at 6 months postpartum using latent profile analysis. This approach will allow identifying subgroups of mothers who share similar symptom severity experiences (profile) and those who are at-risk for worse symptom experiences so that personalized interventions can be developed. Aim 2. Examine individual-, relationship-, and community-level social determinants of health (SDOH) associated with each symptom profile. This will provide important knowledge as to which SDOH influence postpartum symptom profiles. Aim 3. Examine the association between allostatic load and each symptom profile. Allostatic load is a marker of cumulative physiological wear and tear that has a subsequent impact on cardiovascular and metabolic health (e.g., obesity), which contribute to maternal mortality and morbidity. Yet, the relationship between allostatic load and postpartum symptom profiles is unknown. Therefore, examining this relationship will provide novel insights into the health risks of postpartum mothers that will contribute to new targeted intervention strategies. This study aligns well with the National Institute of Nursing Research Strategic Plan to promote personalized symptom management and special interest priority in SDOH. Findings will provide important knowledge that can advance our understanding of postpartum symptom profiles and SDOH to inform future research. Training: The mentorship team with substantive and methodological expertise will support the applicant’s training to successfully conduct the study and prepare for her future steps as a nurse scientist. The following training goals are to gain and expand knowledge in: (1) complex postpartum symptom experiences and SDOH; (2) advanced quantitative methods used to characterize postpartum symptom profiles; (3) methods used in symptom science research and analysis of large data; and (4) intervention development to improve postpartum symptom experiences.

摘要：美国每年有 380 万名女性分娩。 产后会出现一系列的症状，例如睡眠障碍、产后抑郁症等 与产后体重滞留和长期体重增加有关，增加心血管风险 因此，产后症状及其影响会影响母亲的整体健康和生育质量。 生活中产后症状常常同时出现并且相互关联，称为症状。 与单独表现的症状相比，症状群更难以管理和管理。 先前的研究重点关注个体症状的严重程度或 发生，这限制了我们对产后症状群如何表现和影响健康的理解。 此外，先前研究中缺乏种族多样性，在理解种族差异方面造成了严重差距。 本研究将使用联邦资助的“社区儿童”研究的数据。 健康网络，将包括 940 名黑人和 408 名西班牙裔母亲（占样本的 76%）。 目标 1. 使用潜伏期识别产后 6 个月时具有不同症状特征的母亲亚组 这种方法将允许识别具有相似症状严重程度的母亲亚组。 经历（个人资料）和那些有可能出现更严重症状经历的人，以便个性化 目标 2：检查个人、关系和社区层面的社会。 与每种症状相关的健康决定因素（SDOH）这将提供重要的知识。 目标 3. 检查不同稳态之间的关联。 负荷和每种症状特征是累积生理磨损的标志。 随后对心血管和代谢健康（例如肥胖）产生影响，从而导致孕产妇 然而，代谢负荷和产后症状之间的关系是。 因此，研究这种关系将为了解产后的健康风险提供新的见解。 这项研究与国家计划非常吻合。 护理研究所战略计划促进个性化症状管理和特殊治疗 对 SDOH 的兴趣优先 调查结果将提供重要的知识，可以增进我们对 SDOH 的理解。 产后症状概况和 SDOH 为未来的研究提供信息：指导团队。 实质性和方法学专业知识将支持申请人的培训以成功进行研究 并为她作为护士科学家的未来步骤做好准备以下培训目标是获得和扩展。 知识：(1) 复杂的产后症状经历和 SDOH；(2) 先进的定量方法； (3)症状科学研究所使用的方法和 大数据分析；(4) 改善产后症状体验的干预措施。

项目成果

Maternal Psychological Symptom Trajectories From 2 to 24 Months Postpartum: A Latent Class Growth Analysis.

产后 2 至 24 个月的母亲心理症状轨迹：潜在类别增长分析。

• 发表时间: 2024-05-01
• 影响因子: 2.5
• 作者: Scroggins, Jihye Kim;Reuter;Brandon, Debra;Yang, Qing
• 通讯作者: Yang, Qing

Examination of Social Determinants of Health Characteristics Influencing Maternal Postpartum Symptom Experiences.

影响母亲产后症状经历的健康特征社会决定因素的检查。

• 发表时间: 2024-01-05
• 作者: Scroggins, Jihye Kim;Yang, Qing;Tully, Kristin P;Reuter;Brandon, Debra
• 通讯作者: Brandon, Debra