Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Partner relationship satisfaction and maternal emotional distress in early pregnancy

Authors: Gun-Mette B Røsand, Kari Slinning, Malin Eberhard-Gran, Espen Røysamb, Kristian Tambs

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on partner relationship satisfaction. The second aim was to assess interaction effects between relationship satisfaction and the main predictors.

Methods

Pregnant women enrolled in the Norwegian Mother and Child Cohort Study (n = 51,558) completed a questionnaire with questions about maternal emotional distress, relationship satisfaction, and other risk factors. Associations between 37 predictor variables and emotional distress were estimated by multiple linear regression analysis.

Results

Relationship dissatisfaction was the strongest predictor of maternal emotional distress (β = 0.25). Other predictors were dissatisfaction at work (β = 0.11), somatic disease (β = 0.11), work related stress (β = 0.10) and maternal alcohol problems in the preceding year (β = 0.09). Relationship satisfaction appeared to buffer the effects of frequent moving, somatic disease, maternal smoking, family income, irregular working hours, dissatisfaction at work, work stress, and mother's sick leave (P < 0.05).

Conclusions

Dissatisfaction with the partner relationship is a significant predictor of maternal emotional distress in pregnancy. A good partner relationship can have a protective effect against some stressors.
Literature
1.
Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR: Depression during Pregnancy: Overview of Clinical Factors. Clin Drug Invest. 2004, 24: 157-179. 10.2165/00044011-200424030-00004.CrossRef
2.
Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR: Prevalence of depression during pregnancy: systematic review. Obstet Gynecol. 2004, 103: 698-709. 10.1097/01.AOG.0000116689.75396.5f.CrossRefPubMed
3.
Stern DN: The Motherhood Constellation. 1995, New York: Basic Books
4.
Eberhard-Gran M, Tambs K, Opjordsmoen S, Skrondal A, Eskild A: Depression during pregnancy and after delivery: a repeated measurement study. J Psychosom Obstet Gynaecol. 2004, 25: 15-21. 10.1080/01674820410001737405.CrossRefPubMed
5.
Evans J, Heron J, Francomb H, Oke S, Golding J: Cohort study of depressed mood during pregnancy and after childbirth. BMJ. 2001, 323: 257-260. 10.1136/bmj.323.7307.257.CrossRefPubMedPubMedCentral
6.
Johanson R, Chapman G, Murray D, Johnson I, Cox J: The North Staffordshire Maternity Hospital prospective study of pregnancy-associated depression. J Psychosom Obstet Gynecol. 2000, 21: 93-97. 10.3109/01674820009075614.CrossRef
7.
Talge NM, Neal C, Glover V, Early Stress, Translational Research and Prevention Science Network: Fetal and Neonatal Experience on Child and Adolescent Mental Health: Antenatal maternal stress and long-term effects on child neurodevelopment: how and why?. J Child Psychol Psychiatry. 2007, 48: 245-261. 10.1111/j.1469-7610.2006.01714.x.CrossRefPubMed
8.
Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, Ericksen J, Ellwood D, Buist A: Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008, 108: 147-157. 10.1016/j.jad.2007.10.014.CrossRefPubMed
9.
Ystrom E, Niegel S, Klepp KI, Vollrath ME: The impact of maternal negative affectivity and general self-efficacy on breastfeeding: the Norwegian Mother and Child Cohort Study. J Pediatr. 2008, 152: 68-72. 10.1016/j.jpeds.2007.06.005.CrossRefPubMed
10.
Luoma I, Tamminen T, Kaukonen P, Laippala P, Puura K, Salmelin R, Almquist F: Longitudinal study of maternal depressive symptoms and child well-being. J Am Acad Child Adolesc Psychiatry. 2001, 40: 1367-1374. 10.1097/00004583-200112000-00006.CrossRefPubMed
11.
Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM: Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol. 2010, 202: 5-14. 10.1016/j.ajog.2009.09.007.CrossRefPubMedPubMedCentral
12.
Morse CA, Buist A, Durkin S: First-time parenthood: influences on pre- and postnatal adjustment in fathers and mothers. J Psychosom Obstet Gynecol. 2000, 21: 109-120. 10.3109/01674820009075616.CrossRef
13.
Norbeck JS, Anderson NJ: Life stress, social support, and anxiety in mid- and late-pregnancy among low income women. Res Nurs Health. 1989, 12: 281-287. 10.1002/nur.4770120503.CrossRefPubMed
14.
Witt WP, DeLeire T, Hagen EW, Wichmann MA, Wisk LE, Spear HA, Cheng ER, Maddox T, Hampton J: The prevalence and determinants of antepartum mental health problems among women in the USA: a nationally representative population-based study. Arch Wom Ment Health. 2010, 13: 425-437. 10.1007/s00737-010-0176-0.CrossRef
15.
Hobfoll SE, Ritter C, Lavin J, Hulsizer MR, Cameron RP: Depression prevalence and incidence among inner-city pregnant and postpartum women. J Consult Clin Psychol. 1995, 63: 445-453. 10.1037/0022-006X.63.3.445.CrossRefPubMed
16.
Rich-Edwards JW, Kleinman K, Abrams A, Harlow BL, Mc Laughlin TJ, Joffe H, Gillman MW: Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. J Epidemiol Community Health. 2006, 60: 221-227. 10.1136/jech.2005.039370.CrossRefPubMedPubMedCentral
17.
Melville JL, Gavin A, Guo Y, Fan MY, Katon WJ: Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstet Gynecol. 2010, 116: 1064-1070. 10.1097/AOG.0b013e3181f60b0a.CrossRefPubMedPubMedCentral
18.
Gotlib IH, Whiffen VE, Mount JH, Milne K, Cordy NI: Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum. J Consult Clin Psychol. 1989, 57: 269-274. 10.1037/0022-006X.57.2.269.CrossRefPubMed
19.
Kitamura T, Shima S, Sugawara M, Toda MA: Clinical and psychosocial correlates of antenatal depression: a review. Psychother Psychosom. 1996, 65: 117-123. 10.1159/000289062.CrossRefPubMed
20.
Pereira PK, Lovisi GM, Pilowsky DL, Lima LA, Legay LF: Depression during pregnancy: prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil. Cad Saude Publica. 2009, 25: 2725-2736.PubMed
21.
Bottomley KL, Lancaster SJ: The association between depressive symptoms and smoking in pregnant adolescents. Psychol Health Med. 2008, 13: 574-582. 10.1080/13548500801927121.CrossRefPubMed
22.
Jomeen J, Martin CR: Assessment and relationship of sleep quality to depression in early pregnancy. J Reprod Infant Psychol. 2007, 25: 87-99. 10.1080/02646830601117308.CrossRef
23.
Rubertsson C, Waldenström U, Wickberg B: Depressive mood in early pregnancy: prevalence and women at risk in a national Swedish sample. J Reprod Infant Psychol. 2003, 21: 113-123. 10.1080/0264683031000124073.CrossRef
24.
Cohen S, Wills TA: Stress, social support, and the buffering hypothesis. Psychol Bull. 1985, 98: 310-357. 10.1037/0033-2909.98.2.310.CrossRefPubMed
25.
Cooke BD, Rossman MM, McCubbin HI, Pattersson JM: Examining the Definition and Assessment of Social Support: A Resource for Individuals and Families. Family Relations. 1988, 37: 211-216. 10.2307/584322.CrossRef
26.
Dalgard OS, Bjork S, Tambs K: Social support, negative life events and mental health. Br J Psychiatry. 1995, 166: 29-34. 10.1192/bjp.166.1.29.CrossRefPubMed
27.
Olstad R, Sexton H, Sogaard AJ: The Finnmark Study. A prospective population study of the social support buffer hypothesis, specific stressors and mental distress. Soc Psychiatry Psychiatr Epidemiol. 2001, 36: 582-589. 10.1007/s127-001-8197-0.CrossRefPubMed
28.
Magnus P, Irgens LM, Haug K, Nystad W, Skjaerven R, Stoltenberg C, MoBa Study Group: Cohort profile: the Norwegian Mother and Child Cohort Study (MoBa). Int J Epidemiol. 2006, 35: 1146-1150. 10.1093/ije/dyl170.CrossRefPubMed
29.
Nilsen RM, Vollset SE, Gjessing HK, Skjaerven R, Melve KK, Schreuder P, Alsaker ER, Haug K, Daltveit AK, Magnus P: Self-selection and bias in a large prospective pregnancy cohort in Norway. Paediatr Perinat Epidemiol. 2009, 23: 597-608. 10.1111/j.1365-3016.2009.01062.x.CrossRefPubMed
30.
Bulik CM, Von Holle A, Hamer R, Knoph Berg C, Torgersen L, Magnus P, Stoltenberg C, Siega-Riz AM, Sullivan P, Reichborn-Kjennerud T: Patterns of remission, continuation and incidence of broadly defined eating disorders during early pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Psychol Med. 2007, 37: 1109-1118. 10.1017/S0033291707000724.CrossRefPubMedPubMedCentral
31.
32.
33.
Winokur A, Winokur DF, Rickels K, Cox DS: Symptoms of emotional distress in a family planning service: stability over a four-week period. Br J Psychiatry. 1984, 144: 395-399. 10.1192/bjp.144.4.395.CrossRefPubMed
34.
Strand BH, Dalgard OS, Tambs K, Rognerud M: Measuring the mental health status of the Norwegian population: a comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nordic Journal of Psychiatry. 2003, 57: 113-118. 10.1080/08039480310000932.CrossRefPubMed
35.
Tambs K, Moum T: How well can a few questionnaire items indicate anxiety and depression?. Acta Psychiatr Scand. 1993, 87: 364-367. 10.1111/j.1600-0447.1993.tb03388.x.CrossRefPubMed
36.
Nes RB, Roysamb E, Reichborn-Kjennerud T, Harris JR, Tambs K: Symptoms of anxiety and depression in young adults: genetic and environmental influences on stability and change. Twin Res Hum Genet: Journal of International Society for Twin Studies. 2007, 10: 450-461. 10.1375/twin.10.3.450.CrossRef
37.
Blum J, Mehrabian A: Personality and Temperament Correlates of Marital Satisfaction. J Pers. 1999, 67: 93-125. 10.1111/1467-6494.00049.CrossRef
38.
Hendrick SS: A Generic Measure of Relationship Satisfaction. J Marr Fam. 1988, 50: 93-98. 10.2307/352430.CrossRef
39.
Norton R: Measuring marital quality: A critical look at the dependent variable. J Marr Fam. 1983, 45: 141-151. 10.2307/351302.CrossRef
40.
Kristensen P, Nordhagen R, Wergeland E, Bjerkedal T: Job adjustment and absence from work in mid-pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Occup Environ Med. 2008, 65: 560-566. 10.1136/oem.2007.035626.CrossRefPubMed
41.
McFarlane J, Parker B, Soeken K, Bullock L: Assessing for abuse during pregnancy. Severity and frequency of injuries and associated entry into prenatal care. JAMA. 1992, 267: 3176-3178. 10.1001/jama.267.23.3176.CrossRefPubMed
42.
White HR, Labouvie EW: Towards the assessment of adolescent problem drinking. J Stud Alcohol. 1989, stud: 30-37.CrossRef
43.
Saunders JB, Aasland OG, Babor TF, De la Fuente JR, Grant M: Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993, 88: 791-804. 10.1111/j.1360-0443.1993.tb02093.x.CrossRefPubMed
44.
Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ: The lifetime history of major depression in women. Reliability of diagnosis and heritability. Arch Gen Psychiatry. 1993, 50: 863-870.CrossRefPubMed
45.
Graham JW, Hofer SM, MacKinnon DP: Maximizing the Usefulness of Data Obtained with Planned Missing Value Patterns: An Application of Maximum Likelihood Procedures. Multivariate Behav Res. 1996, 31: 197-218. 10.1207/s15327906mbr3102_3.CrossRefPubMed
46.
Eberhard-Gran M, Eskild A, Tambs K, Samuelsen SO, Opjordsmoen S: Depression in postpartum and non-postpartum women: prevalence and risk factors. Acta Psychiatr Scand. 2002, 106: 426-433. 10.1034/j.1600-0447.2002.02408.x.CrossRefPubMed
47.
Nielsen FD, Videbech P, Hedegaard M, Dalby Salvig J, Secher NJ: Postpartum depression: identification of women at risk. BJOG: An International Journal of Obstetrics and Gynaecology. 2000, 107: 1210-1217. 10.1111/j.1471-0528.2000.tb11609.x.CrossRef
48.
O'Hara MW, Neunaber DJ, Zekoski EM: Prospective study of postpartum depression: prevalence, course, and predictive factors. J Abnorm Psychol. 1984, 93: 158-171.CrossRefPubMed
49.
DeLongis A, Capreol M, Holtzman S, O'Brien T, Campbell J: Social support and social strain among husbands and wives: a multilevel analysis. J Fam Psychol. 2004, 18: 470-479. 10.1037/0893-3200.18.3.470.CrossRefPubMed
50.
Spotts EL, Neiderhiser JM, Ganiban J, Reiss D, Lichtenstein P, Hansson K, Cederblad M, Pedersen NL: Accounting for depressive symptoms in women: a twin study of associations with interpersonal relationships. J Affect Disord. 2004, 82: 101-111. 10.1016/j.jad.2003.10.005.CrossRefPubMed
51.
Zlotnick C, Kohn R, Keitner G, DellaGrotta SA: The relationship between quality of interpersonal relationships and major depressive disorder: findings from the National Comorbidity Survey. J Affect Disord. 2000, 59: 205-215. 10.1016/S0165-0327(99)00153-6.CrossRefPubMed
52.
Whisman MA: Marital dissatisfaction and psychiatric disorders: results from the National Comorbidity Survey. J Abnorm Psychol. 1999, 108: 701-706. 10.1037/0021-843X.108.4.701.CrossRefPubMed
53.
Hammen C: Interpersonal stress and depression in women. J Affect Disord. 2003, 74: 49-57. 10.1016/S0165-0327(02)00430-5.CrossRefPubMed
54.
Kumar R, Robson KM: A prospective study of emotional disorders in childbearing women. Br J Psychiatry. 1984, 144: 35-47. 10.1192/bjp.144.1.35.CrossRefPubMed
55.
O'Hara MW: Social support, life events, and depression during pregnancy and the puerperium. Arch Gen Psychiatry. 1986, 43: 569-573.CrossRefPubMed
56.
Beck CT: Predictors of postpartum depression: an update. Nurs Res. 2001, 50: 275-285. 10.1097/00006199-200109000-00004.CrossRefPubMed
57.
Beck CT: Revision of the Postpartum Depression Predictors Inventory. J Obstet Gynecol Neonatal Nurs. 2001, 31: 394-402.CrossRef
58.
Bernazzani O, Saucier JF, David H, Borgeat F: Psychosocial predictors of depressive symptomatology level in postpartum women. J Affect Disord. 1997, 46: 39-49. 10.1016/S0165-0327(97)00077-3.CrossRefPubMed
59.
Chalmers B, Meyer D: Companionship in the perinatal period. A cross-cultural survey of women's experiences. J Nurse Midwifery. 1994, 39: 265-272. 10.1016/0091-2182(94)90031-0.CrossRefPubMed
60.
Logsdon MC, Birkimer JC, Barbee AP: Social Support Providers for Postpartum Women. J Soc Beh Pers. 1997, 12: 89-102.
61.
Brown MA: Social support during pregnancy: a unidimensional or multidimensional construct?. Nurs Res. 1986, 35: 4-9. 10.1097/00006199-198601000-00002.CrossRefPubMed
62.
Hobfoll SE: Social Support: Research, Theory, and Applications from Research on Women. Stress, Social Support, and Women. Edited by: Hobfoll, SE. 1986, Washington D.C: Hemisphere, 239-256.
63.
Engle PL, Scrimshaw SC, Zambrana RE, Dunkel-Schetter C: Prenatal and postnatal anxiety in Mexican women giving birth in Los Angeles. Health Psychol. 1990, 9: 285-299. 10.1037/0278-6133.9.3.285.CrossRefPubMed
64.
Klainin P, Arthur DG: Postpartum depression in Asian cultures: a literature review. Int J Nurs Stud. 2009, 46: 1355-1373. 10.1016/j.ijnurstu.2009.02.012.CrossRefPubMed
65.
Ahlborg G: Physical work load and pregnancy outcome. J Occup Environ Med. 1995, 37: 941-944. 10.1097/00043764-199508000-00009.CrossRefPubMed
66.
Andrea H, Bultmann U, Beurskens AJ, Swaen GM, van Schayck CP, Kant IJ: Anxiety and depression in the working population using the HAD Scale--psychometrics, prevalence and relationships with psychosocial work characteristics. Soc Psychiatry Psychiatr Epidemiol. 2004, 39: 637-646. 10.1007/s00127-004-0797-6.CrossRefPubMed
67.
Plaisier I, de Bruijn JG, de Graaf R, ten Have M, Beekman AT, Penninx BW: The contribution of working conditions and social support to the onset of depressive and anxiety disorders among male and female employees. Soc Sci Med. 2007, 64: 401-410. 10.1016/j.socscimed.2006.09.008.CrossRefPubMed
68.
Sanne B, Mykletun A, Dahl AA, Moen BE, Tell GS: Testing the Job Demand-Control-Support model with anxiety and depression as outcomes: the Hordaland Health Study. Occ Med (Oxford). 2005, 55: 463-473. 10.1093/occmed/kqi071.CrossRef
69.
Stansfeld SA, Fuhrer R, Shipley MJ, Marmot MG: Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study. Occup Environ Med. 1999, 56: 302-307. 10.1136/oem.56.5.302.CrossRefPubMedPubMedCentral
70.
Virtanen M, Honkonen T, Kivimaki M, Ahola K, Vahtera J, Aromaa A, Lonnquist J: Work stress, mental health and antidepressant medication findings from the Health 2000 Study. J Affect Disord. 2007, 98: 189-197. 10.1016/j.jad.2006.05.034.CrossRefPubMed
71.
Iacovides A, Fountoulakis KN, Kaprinis S, Kaprinis G: The relationship between job stress, burnout and clinical depression. J Affect Disord. 2003, 75: 209-221. 10.1016/S0165-0327(02)00101-5.CrossRefPubMed
72.
Plaisier I, de Bruijn JG, Smit JH, de Graaf R, ten Have M, Beekman AT, van Dyck R, Penninx BW: Work and family roles and the association with depressive and anxiety disorders: differences between men and women. J Affect Disord. 2008, 105: 63-72. 10.1016/j.jad.2007.04.010.CrossRefPubMed
73.
Lubin B, Gardener SH, Roth A: Mood and somatic symptoms during pregnancy. Psychosom Med. 1975, 37: 136-146.CrossRefPubMed
74.
Kelly RH, Russo J, Katon W: Somatic complaints among pregnant women cared for in obstetrics: normal pregnancy or depressive and anxiety symptom amplification revisited?. Gen Hosp Psychiatry. 2001, 23: 107-113. 10.1016/S0163-8343(01)00129-3.CrossRefPubMed
75.
Brown S, Lumley J: Physical health problems after childbirth and maternal depression at six to seven months postpartum. BJOG: An International Journal of Obstetrics and Gynaecology. 2000, 107: 1194-1201. 10.1111/j.1471-0528.2000.tb11607.x.CrossRef
76.
Naerde A, Tambs K, Mathiesen KS, Dalgard OS, Samuelsen SO: Symptoms of anxiety and depression among mothers of pre-school children: effect of chronic strain related to children and child care-taking. J Affect Disord. 2000, 58: 181-199. 10.1016/S0165-0327(99)00119-6.CrossRefPubMed
77.
Swendsen JD, Merikangas KR: The comorbidity of depression and substance use disorders. Clin Psychol Rev. 2000, 20: 173-189. 10.1016/S0272-7358(99)00026-4.CrossRefPubMed
78.
Mattisson C, Bogren M, Horstmann V, Tambs K, Munk-Jorgensen P, Nettelbladt P: Risk factors for depressive disorders in the Lundby cohort--a 50 year prospective clinical follow-up. J Affect Disord. 2009, 113: 203-215. 10.1016/j.jad.2008.07.002.CrossRefPubMed
79.
Pajulo M, Savonlahti E, Sourander A, Herenius H, Piha J: Antenatal depression, substance dependency and social support. J Affect Disord. 2001, 65: 9-17. 10.1016/S0165-0327(00)00265-2.CrossRefPubMed
80.
Ulrich-Jakubowski D, Russell DW, O'Hara MW: Marital adjustment difficulties: Cause or consequence of depressive symptomatology?. J Soc Clin Psychol. 1988, 7: 312-318. 10.1521/jscp.1988.7.4.312.CrossRef
81.
Wittchen HU, Pfister H: DIA-X Interviews (M-CIDI). 1997, Frankfurt, Germany: Swets & Zeitlinger
82.
Gjerde L, Røysamb E, Czajkowski N, Reichborn-Kjennerud T, Ørstavik RE, Kendler KS, Tambs K: Strong genetic correlation between interview-assessed internalizing disorders and a brief self-report symptom scale. Twin Res Hum Genet.
83.
Hartge P: Participation in population studies. Epidemiology. 2006, 17: 252-254. 10.1097/01.ede.0000209441.24307.92.CrossRefPubMed
84.
Chokka P: Postpartum Depression: Part 1. The Canadian Journal of CME. 2002, 14: 37-48.
85.
Hayes BA, Muller R, Bradley BS: Perinatal depression: a randomized controlled trial of an antenatal education intervention for primiparas. Birth. 2001, 28: 28-35. 10.1046/j.1523-536x.2001.00028.x.CrossRefPubMed
Metadata
Title
Partner relationship satisfaction and maternal emotional distress in early pregnancy
Authors
Gun-Mette B Røsand
Kari Slinning
Malin Eberhard-Gran
Espen Røysamb
Kristian Tambs
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-161

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue

Research article

Military veteran mortality following a survived suicide attempt

Research article

Ten-year trends in overweight and obesity in the adult Portuguese population, 1995 to 2005

Research article

RH knowledge and service utilization among unmarried rural-to-urban migrants in three major cities, China

Study protocol

Biological monitoring of pesticide exposures in residents living near agricultural land

Research article

Higher body mass index may induce asthma among adolescents with pre-asthmatic symptoms: a prospective cohort study

Research article

Loss of interest, depressed mood and impact on the quality of life: Cross-sectional survey