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      Zur Bedeutung von sozialer Unterstützung während der Schwangerschaft

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          Abstract

          Eine wachsende Zahl an Studien dokumentiert die negativen Auswirkungen von mütterlichen psychosozialen Stressoren (z. B. mütterliche Depression) und gesundheitsrelevanten Verhaltensweisen (z. B. Nikotin- und Alkoholkonsum) während der Schwangerschaft auf den Geburtsausgang. Jedoch werden mütterliche Ressourcen in diesem Kontext noch unzureichend berücksichtigt. Das Ziel ist es daher, die Bedeutung sozialer Unterstützung als frühe Ressource im Schwangerschaftsverlauf und zum Zeitpunkt der Geburt im Hinblick auf das Gesundheitsverhalten der Schwangeren und im Hinblick auf Geburtsmaße zu untersuchen. Die Datenbanken Web of Science und PubMed wurden entsprechend nach deutsch- und englischsprachigen Beiträgen für den Zeitraum 2003 bis 2013 durchsucht. 23 Studien erfüllten die Auswahlkriterien. Die Ergebnisse verdeutlichen, dass die Befundlage sehr inkonsistent ist, was teilweise auf die unterschiedlichen Definitionen sozialer Unterstützung und die Nutzung verschiedener Erhebungsinstrumente zurückzuführen ist. Des Weiteren fehlt es an Studien zur Bedeutung sozialer Unterstützung im Kontext mütterlicher psychosozialer Stressoren und Geburtsmaßen. Es bedarf weiterer Studien an Risiko- und Allgemeinpopulationen, die auf der Basis eines fundierten Rahmenkonzeptes mögliche Effekte der sozialen Unterstützung differenziert analysieren können.

          Impact of social support during pregnancy

          A growing body of literature documents the effects of maternal psychosocial stress (e. g., maternal depression) and health-related behaviors (e. g., nicotine and alcohol consumption) on birth outcomes. However, maternal resources in this context are still considered inadequate. The objective was to investigate the role of social support as a resource early in the course of pregnancy and at birth in relation to the health behavior of pregnant women and birth outcomes. The Web of Science and PubMed databases were searched for German and English language articles from 2003 through 2013 inclusive. Twenty-three studies fulfilled the selection criteria. Results of this review indicate that findings are often inconsistent, which may in part be due to differences in social support definitions and psychometric instruments. In addition, there is a lack of studies examining the impact of social support on the relationship between maternal psychosocial stress and birth outcomes. Studies in risk and on the general population as well as longitudinal studies are needed to test different causal relationships between social support, maternal psychosocial stress, and birth outcomes.

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          Most cited references62

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          Maternal stress and preterm birth.

          This study examined a comprehensive array of psychosocial factors, including life events, social support, depression, pregnancy-related anxiety, perceived discrimination, and neighborhood safety in relation to preterm birth (<37 weeks) in a prospective cohort study of 1,962 pregnant women in central North Carolina between 1996 and 2000, in which 12% delivered preterm. There was an increased risk of preterm birth among women with high counts of pregnancy-related anxiety (risk ratio (RR) = 2.1, 95% confidence interval (CI): 1.5, 3.0), with life events to which the respondent assigned a negative impact weight (RR = 1.8, 95% CI: 1.2, 2.7), and with a perception of racial discrimination (RR = 1.4, 95% CI: 1.0, 2.0). Different levels of social support or depression were not associated with preterm birth. Preterm birth initiated by labor or ruptured membranes was associated with pregnancy-related anxiety among women assigning a high level of negative impact weights (RR = 3.0, 95% CI: 1.7, 5.3). The association between high levels of pregnancy-related anxiety and preterm birth was reduced when restricted to women without medical comorbidities, but the association was not eliminated. The prospective collection of multiple psychosocial measures on a large population of women indicates that a subset of these factors is associated with preterm birth.
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            Prenatal depression effects on early development: a review.

            This review of recent research on prenatal depression suggests that it is a strong predictor of postpartum depression and is more common than postpartum depression. Prenatal depression has been associated with excessive activity and growth delays in the fetus as well as prematurity, low birthweight, disorganized sleep and less responsiveness to stimulation in the neonate. Infants of depressed mothers have difficult temperament, and later in development attentional, emotional and behavioral problems have been noted during childhood and adolescence, as well as chronic illnesses in adulthood. Several variables have confounded the effects of prenatal depression including comorbid anxiety and anger as well as stressful life events. Potential mediating variables are low prenatal maternal dopamine and serotonin levels and elevated cortisol and norepinephrine. The associated intrauterine artery resistance may limit blood flow, oxygen and nutrients to the fetus. Some studies also suggest the heritability of developmental problems for the children of prenatally depressed mothers, including ADHD and antisocial behavior. Multivariate, longitudinal research is needed to disentangle these confounding and mediating variables. Copyright © 2010 Elsevier Inc. All rights reserved.
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              Functional roles of social support within the stress and coping process: A theoretical and empirical overview

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                Author and article information

                Journal
                pru
                Psychologische Rundschau
                Hogrefe Verlag, Göttingen
                0033-3042
                2190-6238
                April 2014
                : 65
                : 2
                : 57-74
                Author notes
                Dipl.-Psych. Franziska Ulrich, Prof. Dr. Franz Petermann, Zentrum für Klinische Psychologie und Rehabilitation, der Universität Bremen, Grazer Str. 6, 28359 Bremen, E-Mail: f.ulrich@ 123456uni-bremen.de , E-Mail: fpeterm@ 123456uni-bremen.de
                Article
                pru_65_2_57
                10.1026/0033-3042/a000197
                5b24ce79-a545-4d3f-88d7-a0ffa94eab96
                Copyright @ 2014
                History
                Categories
                Originalia

                Psychology
                Gesundheitsverhalten,Überblick,Schwangerschaft,soziale Unterstützung,birth outcome,health behavior,pregnancy,review,social support,Geburtsmaße

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