Abstract
Intimate partner relationship quality during the child-bearing years has implications for maternal health. The purpose of this study was to test whether partner satisfaction, partner conflict, and their interaction predicted maternal cardio-metabolic health at 12-months postpartum. Women were recruited in 5 U.S. sites. Partner conflict and satisfaction were measured at 6-months postpartum, and cardio-metabolic indicators (blood pressure, waist–hip ratio, glycosylated hemoglobin, total cholesterol:HDL ratio) were assessed at 6- and 12-months. Cardio-metabolic indices were scored continuously (CM risk) and using clinical risk cutoffs (CM scores). A significant conflict-by-satisfaction interaction emerged for the CM risk, b(SE) = .043 (.016), p = .006, and CM scores, b(SE)= .089 (.028), p = .002, such that when partner satisfaction was low, low partner conflict was associated with poorer postpartum cardio-metabolic health. This is the first study to examine close relationships and cardio-metabolic health during the child-bearing years, an issue warranting further attention.
Similar content being viewed by others
Abbreviations
- BMI:
-
Body mass index
- CCHN:
-
Community Child and Health Network
- DAS:
-
Dyadic Adjustment Scale
- DBP:
-
Diastolic blood pressure
- DBS:
-
Dried blood spot
- FPL:
-
Federal poverty line
- HDL:
-
High density lipoprotein
- HPA:
-
Hypothalamic-pituitary-adrenal
- MAP:
-
Mean arterial pressure
- SBP:
-
Systolic blood pressure
- WHR:
-
Waist–hip ratio
References
Abbey, A., Abramis, D. J., & Caplan, R. D. (1985). Effects of different sources of social support and social-conflict on emotional well-being. Basic and Applied Social Psychology, 6, 111–129. https://doi.org/10.1207/s15324834basp0602_2
Adegboye, A. R., Anderssen, S. A., Froberg, K., Sardinha, L. B., Heitmann, B. L., Steene-Johannessen, J., et al. (2011). Recommended aerobic fitness level for metabolic health in children and adolescents: a study of diagnostic accuracy. British Journal of Sports Medicine, 45, 722–728. https://doi.org/10.1136/bjsm.2009.068346
BeLue, R., Schafer, P., Chung, B., Vance, M., Lanzi, R. G., O’Campo, P., et al. (2014). Evaluation of the Community Child Health Research Network (CCHN) community-academic partnership. Journal of Health Disparities Research and Practice, 7, 51–66.
Birmingham, W. C., Uchino, B. N., Smith, T. W., Light, K. C., & Butner, J. (2015). It’s complicated: Marital ambivalence on ambulatory blood pressure and daily interpersonal functioning. Annals of Behavioral Medicine, 49, 743–753. https://doi.org/10.1007/s12160-015-9709-0
Brage, S., Wedderkopp, N., Ekelund, U., Franks, P. W., Wareham, N. J., Andersen, L. B., et al. (2004). Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: The European Youth Heart Study (EYHS). Diabetes Care, 27, 2141–2148.
Brown, M. A. (1994). Marital discord during pregnancy: A family systems approach. Family Systems Medicine, 12, 221–234.
Cornier, M. A., Dabelea, D., Hernandez, T. L., Lindstrom, R. C., Steig, A. J., Stob, N. R., et al. (2008). The metabolic syndrome. Endocrine Reviews, 29, 777–822. https://doi.org/10.1210/er.2008-0024
Damsgaard, C. T., Dalskov, S. M., Laursen, R. P., Ritz, C., Hjorth, M. F., Lauritzen, L., et al. (2014). Provision of healthy school meals does not affect the metabolic syndrome score in 8–11-year-old children, but reduces cardiometabolic risk markers despite increasing waist circumference. British Journal of Nutrition, 112, 1826–1836. https://doi.org/10.1017/S0007114514003043
DeLongis, A., Capreol, M., Holtzman, S., O’Brien, T., & Campbell, J. (2004). Social support and social strain among husbands and wives: A multilevel analysis. Journal of Family Psychology, 18, 470–479. https://doi.org/10.1037/0893-3200.18.3.470
Dennis, C. L., & Ross, L. (2006). Women’s perceptions of partner support and conflict in the development of postpartum depressive symptoms. Journal of Advanced Nursing, 56, 588–599. https://doi.org/10.1111/j.1365-2648.2006.04059.x
Dunkel Schetter, C. (2011). Psychological science on pregnancy: Stress processes, biopsychosocial models, and emerging research issues. Annual Review of Psychology, 62, 531–558. https://doi.org/10.1146/annurev.psych.031809.130727
Eisenmann, J. C. (2008). On the use of a continuous metabolic syndrome score in pediatric research. Cardiovascular Diabetology, 7, 17. https://doi.org/10.1186/1475-2840-7-17
Ekelund, U., Brage, S., Franks, P. W., Hennings, S., Emms, S., & Wareham, N. J. (2005). Physical activity energy expenditure predicts progression toward the metabolic syndrome independently of aerobic fitness in middle-aged healthy Caucasians: The Medical Research Council Ely Study. Diabetes Care, 28, 1195–1200.
Essex, M. J., Klein, M. H., Cho, E., & Kraemer, H. C. (2003). Exposure to maternal depression and marital conflict: Gender differences in children’s later mental health symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 728–737. https://doi.org/10.1097/01.CHI.0000046849.56865.1D
Fikree, F. F., & Bhatti, L. I. (1999). Domestic violence and health of Pakistani women. International Journal of Gynaecology and Obstetrics, 65, 195–201.
Fincham, F. D., & Linfield, K. J. (1997). A new look at marital quality: Can spouses feel positive and negative about their marriage? Journal of Family Psychology, 11, 489–502.
Franks, P. W., Ekelund, U., Brage, S., Wong, M. Y., & Wareham, N. J. (2004). Does the association of habitual physical activity with the metabolic syndrome differ by level of cardiorespiratory fitness? Diabetes Care, 27, 1187–1193. https://doi.org/10.2337/diacare.27.5.1187
Gable, S. L., & Reis, H. T. (2001). Appetitive and aversive social interaction In Close romantic relationships: Maintenance and enhancement (pp. 169–194).
Gould Rothberg, B. E., Magriples, U., Kershaw, T. S., Rising, S. S., & Ickovics, J. R. (2011). Gestational weight gain and subsequent postpartum weight loss among young, low-income, ethnic minority women. American Journal of Obstetrics Gynecology, 204, 52e1–52e11. https://doi.org/10.1016/j.ajog.2010.08.028
Groer, M. W., Jevitt, C. M., Sahebzamani, F., Beckstead, J. W., & Keefe, D. L. (2013). Breastfeeding status and maternal cardiovascular variables across the postpartum. Journal of Womens Health (Larchmt), 22, 453–459. https://doi.org/10.1089/jwh.2012.3981
Grundy, S. M. (2015). Metabolic syndrome update. Trends in Cardiovascular Medicine. https://doi.org/10.1016/j.tcm.2015.10.004
Gunderson, E. P., Lewis, C. E., Murtaugh, M. A., Quesenberry, C. P., Smith West, D., & Sidney, S. (2004). Long-term plasma lipid changes associated with a first birth: The coronary artery risk development in young adults study. American Journal of Epidemiology, 159, 1028–1039. https://doi.org/10.1093/aje/kwh146
Hamelin-Brabant, L., de Montigny, F., Roch, G., Deshaies, M. H., Mbourou-Azizah, G., Da Silva, R. B., et al. (2015). Perinatal vulnerability and social-support during the postnatal period: a review of the literature. Sante Publique, 27, 27–37.
Hassert, S., Kurpius, S. E., & Tracey, T. J. (2015). Testing a conceptual model of postpartum depressive symptoms in the first year. Women and Health, 55, 700–716. https://doi.org/10.1080/03630242.2015.1039181
Hill, A., Pallitto, C., McCleary-Sills, J., & Garcia-Moreno, C. (2016). A systematic review and meta-analysis of intimate partner violence during pregnancy and selected birth outcomes. International Journal of Gynaecology and Obstetrics, 133, 269–276. https://doi.org/10.1016/j.ijgo.2015.10.023
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. Plos Medicine, 7, e1000316. https://doi.org/10.1371/journal.pmed.1000316
Hostinar, C. E., Ross, K. M., Chen, E., & Miller, G. E. (2017). Early-life socioeconomic disadvantage and metabolic health disparities. Psychosomatic Medicine, 79, 514–523. https://doi.org/10.1097/PSY.0000000000000455
IBM. (2016). IBM SPSS for windows (version 24.0). Armonk, NY: IBM Corp.
Jewell, S. L., Luecken, L. J., Gress-Smith, J., Crnic, K. A., & Gonzales, N. A. (2015). Economic stress and cortisol among postpartum low-income Mexican American women: Buffering influence of family support. Behavioral Medicine, 41, 138–144. https://doi.org/10.1080/08964289.2015.1024603
Kiecolt-Glaser, J. K., & Newton, T. L. (2001). Marriage and health: His and hers. Psychological Bulletin, 127, 472–503.
Kimmel, P. L., Peterson, R. A., Weihs, K. L., Shidler, N., Simmens, S. J., Alleyne, S., et al. (2000). Dyadic relationship conflict, gender, and mortality in urban hemodialysis patients. Journal of the American Society of Nephrology, 11, 1518–1525.
Kingsbury, A. M., Hayatbakhsh, R., Mamun, A. M., Clavarino, A. M., Williams, G., & Najman, J. M. (2015). Trajectories and predictors of women’s depression following the birth of an infant to 21 years: A longitudinal study. Maternal and Child Health Journal, 19, 877–888. https://doi.org/10.1007/s10995-014-1589-6
Lau, Y. (2011). A longitudinal study of family conflicts, social support, and antenatal depressive symptoms among Chinese women. Archives of Psychiatric Nursing, 25, 206–219. https://doi.org/10.1016/j.apnu.2010.07.009
Lau, Y., & Keung, D. W. (2007). Correlates of depressive symptomatology during the second trimester of pregnancy among Hong Kong Chinese. Social Science and Medicine, 64, 1802–1811. https://doi.org/10.1016/j.socscimed.2007.01.001
Lau, Y., & Wong, D. F. (2008). The role of social support in helping Chinese women with perinatal depressive symptoms cope with family conflict. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 37, 556–571. https://doi.org/10.1111/j.1552-6909.2008.00273.x
Lawrence, E., Rothman, A. D., Cobb, R. J., Rothman, M. T., & Bradbury, T. N. (2008). Marital satisfaction across the transition to parenthood. Journal of Family Psychology, 22, 41–50. https://doi.org/10.1037/0893-3200.22.1.41
Magriples, U., Boynton, M. H., Kershaw, T. S., Lewis, J., Rising, S. S., Tobin, J. N., et al. (2015). The impact of group prenatal care on pregnancy and postpartum weight trajectories. American Journal of Obstetrics Gynecology, 213, e681–e689. https://doi.org/10.1016/j.ajog.2015.06.066
Mattson, R. E., Rogge, R. D., Johnson, M. D., Davidson, E. K. B., & Fincham, F. D. (2013). The positive and negative semantic dimensions of relationship satisfaction. Personal Relationships, 20, 328–355. https://doi.org/10.1111/j.1475-6811.2012.01412.x
Mcfarlane, J., Parker, B., Soeken, K., & Bullock, L. (1992). Assessing for abuse during pregnancy—severity and frequency of injuries and associated entry into prenatal-care. JAMA-Journal of the American Medical Association, 267, 3176–3178. https://doi.org/10.1001/jama.267.23.3176
Millan, J., Pinto, X., Munoz, A., Zuniga, M., Rubies-Prat, J., Pallardo, L. F., et al. (2009). Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention. Vascular Health and Risk Management, 5, 757–765.
Mozumdar, A., & Liguori, G. (2011). Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999–2006. Diabetes Care, 34, 216–219. https://doi.org/10.2337/dc10-0879
Nayak, M. B., & Al-Yattama, M. (1999). Assault victim history as a factor in depression during pregnancy. Obstetrics and Gynecology, 94, 204–208. https://doi.org/10.1016/S0029-7844(99)00267-7
Okun, M. A., & Lockwood, C. J. (2003). Does level of assessment moderate the relation between social support and social negativity?: A meta-analysis. Basic and Applied Social Psychology, 25, 15–35.
Owen, M. T., & Cox, M. J. (1997). Marital conflict and the development of infant-parent attachment relationships. Journal of Family Psychology, 11, 152–164. https://doi.org/10.1037/0893-3200.11.2.152
Owoeye, A. O., Aina, O. F., & Morakinyo, O. (2006). Risk factors of postpartum depression and EPDS scores in a group of Nigerian women. Tropical Doctor, 36, 100–103. https://doi.org/10.1258/004947506776593341
Parikh, N. I., Laraia, B., Nah, G., Singhal, M., Vittinghoff, E., Coleman-Phox, K., et al. (2017). Abstract P319: Do pregnancy complications elevate cardiovascular risk after pregnancy? An examination of cardiometabolic biomarker and risk factor trajectories up to the first nine months postpartum in low income women. Circulation, 135, AP319.
Preacher, K. J., Curran, P. J., & Bauer, D. J. (2003). Simple intercepts, simple slopes, and regions of significance in MLR 2-way interactions. Retrieved July 15, 2016 from http://quantpsy.org/interact/mlr2.htm.
Ramey, S. L., Schafer, P., DeClerque, J. L., Lanzi, R. G., Hobel, C., Shalowitz, M., et al. (2015). The preconception stress and resiliency pathways model: A multi-level framework on maternal, paternal, and child health disparities derived by community-based participatory research. Maternal and Child Health Journal, 19, 707–719. https://doi.org/10.1007/s10995-014-1581-1
Ramos, R. G., & Olden, K. (2008). The prevalence of metatabolic syndrome among U.S. women of childbearing age. American Journal of Public Health, 98, 1122–1127. https://doi.org/10.2105/AJPH.2007.120055)
Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). Risky families: Family social environments and the mental and physical health of offspring. Psychological Bulletin, 128, 330–366. https://doi.org/10.1037//0033-2909.128.2.330
Robles, T. F., & Kiecolt-Glaser, J. K. (2003). The physiology of marriage: pathways to health. Physiology & Behavior, 79, 409–416. https://doi.org/10.1016/s0031-9384(03)00160-4
Robles, T. F., Slatcher, R. B., Trombello, J. M., & McGinn, M. M. (2014). Marital quality and health: A meta-analytic review. Psychological Bulletin, 140, 140–187. https://doi.org/10.1037/a0031859
Rodie, V. A., Freeman, D. J., Sattar, N., & Greer, I. A. (2004). Pre-eclampsia and cardiovascular disease: Metabolic syndrome of pregnancy? Atherosclerosis, 175, 189–202. https://doi.org/10.1016/j.atherosclerosis.2004.01.038
Ross, K. M., Guardino, C., Dunkel Schetter, C., & Hobel, C. (2018). Interactions between race/ethnicity, poverty status, and pregnancy cardio-metabolic diseases in prediction of postpartum cardio-metabolic health. Ethnicity and Health, 2, 1–16. https://doi.org/10.1080/13557858.2018.1493433
Ross, K. M., Martin, T., Chen, E., & Miller, G. E. (2011). Social encounters in daily life and 2-year changes in metabolic risk factors in young women. Development and Psychopathology, 23, 897–906. https://doi.org/10.1017/S0954579411000381
Ross, K. M., Miller, G., Qadir, S., Keenan-Devlin, L., Leigh, A. K. K., & Borders, A. (2017). Positive and negative aspects of the romantic partner relationship and peripheral inflammation over the second and third trimesters of pregnancy. Psychoneuroendocrinology, 77, 252–260.
Spanier, G. B. (1976). Measuring dyadic adjustment—new scales for assessing quality of marriage and similar dyads. Journal of Marriage and the Family, 38, 15–28. https://doi.org/10.2307/350547
Troxel, W. M., & Matthews, K. (2004). What are the costs of marital conflict and dissolution to children’s physical health? Clinical Child and Family Psychological Review, 7, 29–57.
Uchino, B. N., Bosch, J. A., Smith, T. W., Carlisle, M., Birmingham, W., Bowen, K. S., et al. (2013). Relationships and cardiovascular risk: Perceived spousal ambivalence in specific relationship contexts and its links to inflammation. Health Psychology, 32, 1067–1075. https://doi.org/10.1037/a0033515
Uchino, B. N., Smith, T. W., & Berg, C. A. (2014). Spousal relationship quality and cardiovascular risk: Dyadic perceptions of relationship ambivalence are associated with coronary-artery calcification. Psychological Science, 25, 1037–1042. https://doi.org/10.1177/0956797613520015
Vinokur, A. D., & van Ryn, M. (1993). Social support and undermining in close relationships: Their independent effects on the mental health of unemployed persons. Journal of Personality and Social Psychology, 65, 350–359.
Yakusheva, O., Kapinos, K., & Weiss, M. (2017). Maternal weight after childbirth versus aging-related weight changes. Womens Health Issues, 27, 174–180. https://doi.org/10.1016/j.whi.2016.12.001
Funding
This study was conducted by Community Child Health Network (CCHN) through cooperative agreements with the Eunice Kennedy Shriver National Institute of Child Health and Human Development [UHD44207, U HD44219, U HD44226, U HD44245, U HD44253, U HD54791, U HD54019, U HD44226-05S1, U HD44245-06S1, R03 HD59584] and the National Institute for Nursing Research [U NR008929]. K. Ross is supported through the National Institute for Health [R01 HD073491] and Eunice Kennedy Shriver National Institute of Child Health and Human Development [R01 HD072021-01A1].
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Kharah M. Ross, Christine Guardino, Calvin J. Hobel, and Christine Dunkel Schetter declare that they have no conflict of interest.
Human and animal rights and Informed consent
All procedures were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Ross, K.M., Guardino, C., Hobel, C.J. et al. Partner relationship satisfaction, partner conflict, and maternal cardio-metabolic health in the year following the birth of a child. J Behav Med 41, 722–732 (2018). https://doi.org/10.1007/s10865-018-9947-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-018-9947-2