Pathways From Socioeconomic Status to Prenatal Smoking: A Test of the Reserve Capacity Model.
Irene Yang, Lynne A Hall, Kristin Ashford and 3 others
PMID 27977563WHAT IT FOUND
Lower socioeconomic status in pregnant women was linked to more stress and poorer relationship quality; these were linked to depressive symptoms, which were associated with continuing smoking.
Relationship quality did not buffer stress.
Key findings
01Higher socioeconomic status was associated with lower chronic stressors and higher quality of the primary intimate relationship.
02Higher chronic stressors and lower quality of the primary intimate relationship were associated with higher depressive symptoms, and higher depressive symptoms were associated with prenatal smoking status.
03The quality of the primary intimate relationship did not moderate the relationship between chronic stressors and depressive symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The findings came from secondary analysis of existing data, not a study designed specifically for this question. Smoking status grouping may not have precisely separated nonsmokers, occasional smokers, and women who reduced cigarettes per day. Self-reported smoking and urine cotinine were not correlated in the first trimester and were weakly correlated in the second and third trimesters. The parent study excluded women with several conditions and risk factors, which limits generalizability. Parity data were missing for 17.57% of participants. The analysis tested pathways in a model, not causal effects or treatment outcomes. The sample was mostly White, and race was dichotomized because of limited racial variability.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not conclude that improving stress, depressive symptoms, or relationship quality will reduce prenatal smoking. This study tested associations in existing data, not a treatment effect.