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

基本信息

批准号：
10616481
负责人：
JEANNE L ALHUSEN
金额：
$ 36.79万
依托单位：
UNIVERSITY OF VIRGINIA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-04-01 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10616481
关键词：
Access to Information Address Admission activity Affect Attitude Birth Caring Critical Care Data Development Disabled Persons Disparity Domestic Violence Evaluation Evidence based intervention Female of child bearing age Focus Groups Foundations Future Goals Health Health Personnel Health Promotion Healthcare Healthcare Systems Incidence Individual Infant Intervention Interview Knowledge Low Birth Weight Infant Mediating Mental Depression Mental disorders Methods Mood Disorders Morbidity - disease rate Mothers Neonatal Intensive Care Units Nurse Midwives Nurses Outcome Perinatal Perinatal Care Phase Physicians Policies Predictive Factor Pregnancy Pregnancy Outcome Pregnant Women Premature Birth Prenatal care Provider Psychosocial Stress Recommendation Reporting Research Research Personnel Resources Risk Risk Assessment Risk Factors Role Sampling System Testing Tobacco Underserved Population Violence Woman Women&apos s Group adverse birth outcomes adverse pregnancy outcome barrier to care clinical practice contextual factors depressive symptoms design disability disparity reduction ethnic diversity experience illicit drug use improved infant outcome intimate partner violence maternal outcome mortality perinatal health perinatal outcomes perinatal period population based pregnant preventive intervention protective factors racial diversity risk mitigation sociodemographics substance use symptomatology unintended pregnancy violence prevention women with disabilities

项目摘要

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.

有迹象的妇女越来越怀孕，可能会怀孕的妇女没有迹象的妇女。不良围产期结局的风险增加了。不良出生结果的差异，发现出现低出生体重，早产和新生儿的风险增加一个华丽的。机制是在围产期中遭受不明智的妇女遇到的社会心理压力的风险增加时期。然而，尚未研究THECECT影响妊娠结局的程度。了解心理压力，即IPV和抑郁症状，与不利有关至关重要的出生结果来降低残疾母亲及其的死亡率和死亡率率婴儿，减少妇女和失业妇女之间的围产期护理差异，告知设计有效针对妇女的研究和服务不足的妇女人群以及以及为临床实践和政策变化产生建议。系统地检查心理压力和不良出生结果之间的关联混合方法方法，我们将：1）检查社会心理压力之间的关联（即围产期IPV 通过分析来自残疾和没有残疾的女性的Prames第9阶段的数据； 2）探索经验和障碍通过个人个人的个人和种族多样化的孕妇以及和和具有不同迹象的新母亲； 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护理经验）向妇女提供全面的围产健康健康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，与残疾孕妇没有依据，目的是改善这一不足的人群的围产期护理妇女。干预措施，包括自己的团队计划适应的计划，并测试成功的健康促进预防干预措施，是残疾女性的相关后遗症。优化患有残疾儿童的妇女的怀孕结局。