Archives of Women's Mental Health

, Volume 16, Issue 6, pp 435–451

The balance between stress and personal capital during pregnancy and the relationship with adverse obstetric outcomes: findings from the 2007 Los Angeles Mommy and Baby (LAMB) study

  • Fathima Wakeel
  • Lauren E. Wisk
  • Rebekah Gee
  • Shin M. Chao
  • Whitney P. Witt
Original Article

Abstract

Stress during pregnancy is a salient risk factor for adverse obstetric outcomes. Personal capital during pregnancy, defined as internal and social resources that help women cope with or decrease their exposure to stress, may reduce the risk of poor obstetric outcomes. Using data from the 2007 Los Angeles Mommy and Baby study (N = 3,353), we examined the relationships between the balance of stress and personal capital during pregnancy, or the stress-to-capital ratio (SCR), and adverse obstetric outcomes (i.e., pregnancy complications, preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA)). Women with a higher SCR (i.e., greater stress relative to personal capital during pregnancy) were significantly more likely to experience at least one pregnancy complication, PTB, and lower gestational age, but not LBW or SGA. Accounting for pregnancy complications completely mediated the association between the SCR and PTB. Our findings indicate that experiencing greater stress relative to personal capital during pregnancy is associated with an increased risk for pregnancy complications, PTB, and lower gestational age and that pregnancy complications may be a mechanism by which the SCR is related to adverse obstetric outcomes.

Keywords

Personal capital Maternal stress Obstetric outcomes Preterm birth Pregnancy complications 

References

  1. Adams MM, Shulman HB, Bruce C, Hogue C, Brogan D (1991) The Pregnancy Risk Assessment Monitoring System: design, questionnaire, data collection and response rates. PRAMS Working Group. Paediatr Perinat Epidemiol 5:333–346PubMedCrossRefGoogle Scholar
  2. Ayers S (2001) Assessing stress and coping in pregnancy and postpartum. J Psychosom Obstet Gynaecol 22:13–27PubMedCrossRefGoogle Scholar
  3. Baron RM, Kenny DA (1986) The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51:1173–1182PubMedCrossRefGoogle Scholar
  4. Bell JF, Zimmerman FJ, Almgren GR, Mayer JD, Huebner CE (2006) Birth outcomes among urban African-American women: a multilevel analysis of the role of racial residential segregation. Soc Sci Med 63:3030–3045PubMedCrossRefGoogle Scholar
  5. Bronfenbrenner U (1977) Toward an experimental ecology of human development. Am Psychol 32:513–531CrossRefGoogle Scholar
  6. Bronfenbrenner U (1979) The ecology of human development. Harvard University Press, CambridgeGoogle Scholar
  7. Buka SL, Brennan RT, Rich-Edwards JW, Raudenbush SW, Earls F (2003) Neighborhood support and the birth weight of urban infants. Am J Epidemiol 157:1–8PubMedCrossRefGoogle Scholar
  8. Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385–396PubMedCrossRefGoogle Scholar
  9. Cohen S, Wills TA (1985) Stress, social support, and the buffering hypothesis. Psychol Bull 98:310–357PubMedCrossRefGoogle Scholar
  10. Cohen S, Williamson GM (1987) Perceived stress in a probability sample of the United States. In: Spacaman S, Oskamp S (eds) The social psychology of health. Sage, Newbury Park, pp 31–49Google Scholar
  11. Collin NL, Dunkel-Schetter C, Lobel M, Scrimshaw SC (1993) Social support in pregnancy: psychosocial correlates of birth outcomes and postpartum depression. J Pers Soc Psychol 65:1243–1258CrossRefGoogle Scholar
  12. Coussons-Read ME, Okun ML, Schmitt MP, Giese S (2005) Prenatal stress alters cytokine levels in a manner that may endanger human pregnancy. Psychosom Med 67:625–631PubMedCrossRefGoogle Scholar
  13. Coussons-Read ME, Okun ML, Nettles CD (2007) Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy. Brain Behav Immun 21:343–350PubMedCrossRefGoogle Scholar
  14. Dole N, Savitz DA, Hertz-Picciotto I, Siega-Riz A, McMahon MJ, Buekens P (2003) Maternal stress and preterm birth. Am J Epidemiol 151:14–24CrossRefGoogle Scholar
  15. Dunkel Schetter C (2011) Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol 62:531–558PubMedCrossRefGoogle Scholar
  16. Evans RG, Stoddart GL (2003) Consuming research, producing policy? Am J Public Health 93:371–379PubMedCrossRefGoogle Scholar
  17. Feldman PJ, Dunkel-Schetter C, Sandman CA, Wadhwa PD (2000) Maternal social support predicts birth weight and fetal growth in human pregnancy. Psychosom Med 62:715–725PubMedGoogle Scholar
  18. Fragile Families and Child Wellbeing Study (2003) Mother’s baseline questionnaire. http://www.fragilefamilies.princeton.edu/documentation.asp
  19. Gennaro S, Hennessy MD (2003) Psychological and physiological stress: impact on preterm birth. J Obstet Gynecol Neonatal Nurs 32:668–675PubMedCrossRefGoogle Scholar
  20. Goldenberg RL, Cliver SP, Cutter GR, Hoffman HJ, Copper RR, Gotlieb S, Davis RO (1991) Maternal psychological characteristics and intrauterine growth retardation. J Prenat Perinatal Psychol Health 6:129–134Google Scholar
  21. Hack M, Klein NK, Taylor GH (1995) Long-term developmental outcomes of low birthweight infants. Future Child 5:176–196PubMedCrossRefGoogle Scholar
  22. Halfon N, Hochstein M (2002) Life course health development: an integrated framework for developing health, policy, and research. Milbank Q 80:433–479PubMedCrossRefGoogle Scholar
  23. Hedegaard M, Henriksen TB, Secher NJ, Hatch MC, Sabroe S (1996) Do stressful life events affect duration of gestation and risk of preterm delivery? Epidemiology 7:339–345PubMedCrossRefGoogle Scholar
  24. Heron M (2012) Deaths: leading causes for 2008. Natl Vital Stat Rep 60:1–94PubMedGoogle Scholar
  25. Hobfoll SE, Leiberman JR (1987) Personality and social resources in immediate and continued stress resistance among women. J Pers Soc Psychol 52:18–26PubMedCrossRefGoogle Scholar
  26. Hobfoll SE (2002) Social and psychological resources and adaptation. Rev Gen Psychol 6:307–324CrossRefGoogle Scholar
  27. House JS (1974) Occupational stress and coronary heart disease: a review and theoretical integration. J Health Soc Behav 15:12–27PubMedCrossRefGoogle Scholar
  28. Jesse DE, Graham M, Swanson M (2006) Psychosocial and spiritual factors associated with smoking and substance use during pregnancy in African American and White low-income women. J Obstet Gynecol Neonatal Nurs 35:68–77PubMedCrossRefGoogle Scholar
  29. Kramer MS (2003) The epidemiology of adverse pregnancy outcomes: an overview. J Nutr 133:1592S–1596SPubMedGoogle Scholar
  30. Lazarus RS, Folkman S (1984) Stress, appraisal and coping. Springer, New YorkGoogle Scholar
  31. Lobel M, Dunkel-Schetter C (1990) Conceptualizing stress to study effects on health: environmental, perceptual and emotional components. Anxiety Res 3:213–230CrossRefGoogle Scholar
  32. Lobel M, Dunkel-Schetter C, Scrimshaw SC (1992) Prenatal maternal stress and prematurity: a prospective study of socioeconomically disadvantaged women. Health Psychol 11:32–40PubMedCrossRefGoogle Scholar
  33. Marks NF, Lambert JD (1999) Transition to caregiving, gender, and psychological well-being: prospective evidence from the National Survey of Family and Households, Working paper for NSFHGoogle Scholar
  34. McCormick MC (1985) The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med 312:82–90PubMedCrossRefGoogle Scholar
  35. McEwen BS (1998) Stress, adaptation, and disease. Allostasis and allostatic load. Ann N Y Acad Sci 840:33–44Google Scholar
  36. Misra DP, Guyer B, Allston A (2003) Integrated perinatal health framework. A multiple determinants model with a life span approach. Am J Prev Med 25:65–75PubMedCrossRefGoogle Scholar
  37. Moster D, Lie RT, Markestad T (2008) Long-term medical and social consequences of preterm birth. N Engl J Med 359:62–273CrossRefGoogle Scholar
  38. Newton RW, Hunt LP (1984) Psychosocial stress in pregnancy and its relation to low birth weight. Br Med J (Clin Res Ed) 288:1191–1194CrossRefGoogle Scholar
  39. Olsen IE, Groveman SA, Lawson ML, Clark RH, Zemel BS (2010) New intrauterine growth curves based on United States data. Pediatrics 125:e214–e224PubMedCrossRefGoogle Scholar
  40. Precht DH, Anderson PK, Olsen J (2007) Severe life events and impaired fetal growth: a nation-wide study with complete follow-up. Acta Obstet Gynecol Scand 86:266–275PubMedCrossRefGoogle Scholar
  41. Rini CK, Dunkel-Schetter C, Wadhwa PD, Sandman CA (1999) Psychological adaptation and birth outcomes: the role of personal resources, stress, and sociocultural context in pregnancy. Health Psychol 18:333–345PubMedCrossRefGoogle Scholar
  42. Rondo PHC, Ferreira RF, Nogueira FC, Ribeiro MC, Lobert H, Artes R (2003) Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr 57:266–272PubMedCrossRefGoogle Scholar
  43. Roy-Matton N, Moutquin J, Brown C, Carrier N, Bell L (2011) The impact of perceived maternal stress and other psychosocial risk factors on pregnancy complications. J Obstet Gynaecol Can 33:344–352PubMedGoogle Scholar
  44. Sable MR, Wilkinson DS (2000) Impact of perceived stress, major life events and pregnancy attitudes on low birth weight. Fam Plann Perspect 32:288–294PubMedCrossRefGoogle Scholar
  45. Steer P (2005) The epidemiology of preterm labour. Bjog 112(Suppl 1):1–3PubMedGoogle Scholar
  46. Wadhwa PD, Porto M, Garite T, Chicz-DeMet A, Sandman CA (1998) Maternal corticotropin-releasing hormone levels in the early third trimester predict length of gestation in human pregnancy. Am J Obstet Gynecol 179:1079–1085PubMedCrossRefGoogle Scholar
  47. Wadhwa PD, Culhane JF, Rauh V, Barve SS, Hogan V, Sandman CA, Hobel CJ, Chicz-DeMet A, Dunkel-Schetter C, Garite TJ, Glynn L (2001) Stress, infection and preterm birth: a biobehavioural perspective. Paediatr Perinat Epidemiol 15(Suppl 2):17–29PubMedCrossRefGoogle Scholar
  48. Wadhwa PD, Garite TJ, Porto M, Glynn L, Chicz-DeMet A, Dunkel-Schetter C, Sandman CA (2004) Placental corticotropin-releasing hormone (CRH), spontaneous preterm birth, and fetal growth restriction: a prospective investigation. Am J Obstet Gynecol 191:1063–1069PubMedCrossRefGoogle Scholar
  49. Wakeel, F, Witt WP, Wisk LE, Lu MC, Chao SM (2013) Racial and ethnic disparities in personal capital during pregnancy: findings from the 2007 Los Angeles Mommy and Baby (LAMB) study. Matern Child Health J. doi:10.1007/s10995-013-1256-3
  50. Zhu P, Tao F, Hao J, Sun Y, Jiang X (2010) Prenatal life events stress: implications for preterm birth and infant birthweight. Am J Obstet Gynecol 203(34e):31–38Google Scholar

Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Fathima Wakeel
    • 1
    • 2
  • Lauren E. Wisk
    • 2
  • Rebekah Gee
    • 3
  • Shin M. Chao
    • 4
  • Whitney P. Witt
    • 2
  1. 1.Department of Obstetrics and Gynecology, School of Medicine and Public HealthUniversity of Wisconsin—MadisonMadisonUSA
  2. 2.Department of Population Health Sciences, School of Medicine and Public HealthUniversity of Wisconsin—MadisonMadisonUSA
  3. 3.Department of Health Policy and Systems Management, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansUSA
  4. 4.Child and Adolescent Health ProgramsLos Angeles County Department of MaternalLos AngelesUSA

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