早期儿童保育不稳定和随后的孕产妇健康。

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Womens Health Issues Pub Date : 2024-03-01 DOI:10.1016/j.whi.2023.10.002
Carol Duh-Leong MD, MPP , Caitlin F. Canfield PhD , Anne E. Fuller MD, MS , Rachel S. Gross MD, MS , Nancy E. Reichman PhD
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引用次数: 0

摘要

目的:我们研究了早期儿童保育不稳定性或儿童保育安排的安全性和可靠性与随后的孕产妇健康之间的潜在关联。研究设计:我们对2,836名儿童母亲的调查反馈进行了二次分析,这些母亲参与了“家庭与儿童健康的未来”研究。我们评估了以下托儿措施:不安全托儿、不安全托儿与缺勤、不充分的托儿和紧急托儿支持。我们使用具有稳健标准误差的线性和逻辑回归模型来检验这些指标在儿童3岁时与儿童9岁后的母亲健康结果(整体健康、抑郁和养育压力)之间的关联。然后,我们检查了1岁和3岁儿童保育措施的附加经验对孕产妇健康结果的影响。结果:早期托儿不足增加了后来产妇整体健康状况不佳的几率(调整优势比[aOR], 1.64;95%可信区间[CI], 1.11-2.41)。所有早期儿童保育不稳定措施都增加了母亲抑郁的几率(儿童保育不安全[aOR, 1.64;95% ci, 1.23-2.18];不安全托儿与缺勤[aOR, 1.58];95% ci, 1.13-2.22];儿童保育不足[aOR, 1.75;95% ci, 1.22-2.51])。紧急托儿支持降低了孕产妇不良健康结局的几率(整体健康状况差[aOR, 0.65;95% CI, 0.48 ~ 0.88];抑郁[aOR, 0.73;95% CI, 0.54 ~ 0.99];父母压力[B -0.45];95% CI, -0.80 ~ -0.10])。与短时间体验相比,长时间体验与孕产妇健康有更强的关联。结论:早期托儿不稳定与孕产妇健康存在长期不良关联,紧急托儿支持似乎有利于孕产妇健康。对研究人员、临床医生和决策者来说,这些发现突出了儿童保育不稳定是妇女健康的一个社会决定因素。
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Early Childcare Precarity and Subsequent Maternal Health

Purpose

We examined prospective associations between early childcare precarity, or the security and reliability of childcare arrangements, and subsequent maternal health.

Study Design

We conducted a secondary analysis of survey responses from mothers of 2,836 children in the Future of Families and Child Wellbeing study. We assessed the following childcare measures: insecure childcare, insecure childcare with missed work, inadequate childcare, and emergency childcare support. We used linear and logistic regression models with robust standard errors to examine associations between these measures when the index child was age 3 and maternal health outcomes (overall health, depression, and parenting stress) later when the child was age 9. We then examined additive experiences of childcare measures across child ages 1 and 3 on maternal health outcomes.

Results

Early inadequate childcare was associated with higher odds of later poor maternal overall health (adjusted odds ratio [aOR], 1.64; 95% confidence interval [CI], 1.11–2.41). All early childcare precarity measures were associated with higher odds of maternal depression (insecure childcare [aOR, 1.64; 95% CI, 1.23–2.18]; insecure childcare with missed work [aOR, 1.58; 95% CI, 1.13–2.22]; and inadequate childcare [aOR, 1.75; 95% CI, 1.22–2.51]). Emergency childcare support was associated with lower odds of adverse maternal health outcomes (poor overall health [aOR, 0.65; 95% CI, 0.48 to 0.88]; depression [aOR, 0.73; 95% CI, 0.54 to 0.99]; and parenting stress [B −0.45; 95% CI, −0.80 to −0.10]). Prolonged experiences had stronger associations with maternal health than shorter experiences.

Conclusion

Early childcare precarity has long-term adverse associations with maternal health, and emergency childcare support seems to be favorable for maternal health. These findings highlight childcare precarity as a social determinant of women's health for researchers, clinicians, and decision-makers.

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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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