Psychosocial Stress During First Pregnancy Predicts Infant Health Outcomes in the First Postnatal Year

Abstract

Objectives

To evaluate the impact of psychosocial stress during pregnancy on infant health outcomes in the first postnatal year.

Methods

A sample of 3000 women completed a stress inventory (the Psychosocial Hassles Scale) during their third trimester before first childbirth. Infant health outcomes were measured via maternal report at 1, 6 and 12 months postpartum. Poisson regression was used to model the effect of maternal stress during pregnancy on infant health outcomes in the first year, controlling for age, race/ethnicity, education, insurance coverage, marital status, and cigarette smoking during pregnancy.

Results

Women who were younger, minority, unmarried, publicly insured and without a college degree were more likely to report high levels of prenatal stress. High prenatal stress was a significant predictor of maternal reporting of gastrointestinal illness (p < 0.0001), respiratory illness (p = 0.025), and total illness in the first year (p < 0.0001). High prenatal stress was also a significant predictor of urgent care visits (p < 0.0001) and emergency department visits (p = 0.001). It was not a significant predictor of hospitalizations (p = 0.36).

Conclusions

Maternal prenatal stress is associated with increased maternal reporting of infant illness, as well as increased frequency of both urgent care visits and emergency department visits.

Appendices

Appendix 1: Psychosocial Hassles Scale

Now I am going to ask you about some things that might have occurred during this pregnancy that might have made you feel stressed or upset. Please tell me how much of a hassle the following things were for you—have they caused no stress, some stress, moderate stress, or severe stress for you during your pregnancy?

		No stress	Some stress	Moderate stress	Severe stress	Don’t know	Refuse to respond
a	Worries about food, shelter, health care, and transportation	1	2	3	4	8	9
b	Money worries like paying bills	1	2	3	4	8	9
c	Problems related to family	1	2	3	4	8	9
d	Having to move, either recently or in the future	1	2	3	4	8	9
e	Recent loss of a loved one	1	2	3	4	8	9
f	The pregnancy itself	1	2	3	4	8	9
g	Fights with partner	1	2	3	4	8	9
h	Fights with other family members	1	2	3	4	8	9
i	Work or job problems	1	2	3	4	8	9
j	Problems with your friends	1	2	3	4	8	9
k	Feeling generally overloaded	1	2	3	4	8	9
l	Crime or safety in your neighborhood	1	2	3	4	8	9

Appendix 2: Minor Infant Illness Questionnaires

1-month: Next is a list of illnesses babies may have. Please tell me if your baby has had any of the following problems during the past 4 weeks

		Yes	No	Don’t know	Refuse to respond
a	Cough or cold	1	2	8	9
b	Respiratory infection (respiratory flu, bronchitis, respiratory distress syndrome)	1	2	8	9
c	Jaundice requiring light therapy or BiliBlanket	1	2	8	9
d	Fever of 100.4 °F or more 24 h or more	1	2	8	9
e	Colic: crying/fussiness three or more hours a day	1	2	8	9
f	Thrush (a fungal infection of the mouth)	1	2	8	9
g	Poor weight gain	1	2	8	9
h	Breast milk or formula intolerance	1	2	8	9
i	Food Allergy	1	2	8	9

6-month: Next is a list of illnesses babies may have. Please tell me if your baby has had any of the following problems during the past 4 weeks

		Yes	No	Don’t know	Refuse to respond
a	Cough or cold	1	2	8	9
b	Respiratory infection (respiratory flu, asthma, bronchiolitis, RSV)	1	2	8	9
c	Ear infection	1	2	8	9
d	Fever of 100.4 °F or more 24 h or more	1	2	8	9
e	Constipation	1	2	8	9
f	Diarrhea	1	2	8	9
g	Diaper rash	1	2	8	9
h	Allergic reaction to a new food	1	2	8	9

12-month: Next is a list of illnesses babies may have. Please tell me if your baby has had any of the following problems during the past 4 weeks

		Yes	No	Don’t know	Refuse to respond
a	Cough or cold	1	2	8	9
b	Respiratory infection (respiratory flu, asthma, bronchiolitis, RSV)	1	2	8	9
c	Asthma	1	2	8	9
d	Eczema (a skin rash caused by an allergic reaction)	1	2	8	9
e	Ear infection	1	2	8	9
f	Fever of 100.4 °F or more 24 h or more	1	2	8	9
g	Constipation	1	2	8	9
h	Diarrhea	1	2	8	9
i	Allergic reaction to a new food	1	2	8	9