Maternal and Child Health Journal

, Volume 11, Issue 2, pp 153–159 | Cite as

Prenatal and Parenting Stress on Adolescent Maternal Adjustment: Identifying a High-Risk Subgroup

  • Christina K. Holub
  • Trace S. Kershaw
  • Kathleen A. Ethier
  • Jessica B. Lewis
  • Stephanie Milan
  • Jeannette R. Ickovics
Original Paper


Objectives: Identifying adolescents who are at increased risk for a particularly difficult pregnancy and adjustment into parenthood is important, as the physical and psychological development of their infants rest in the well-being of these new mothers. This study aims to examine the effects of prenatal stress and parenting stress and the association with: (1) adolescent maternal adjustment; and (2) postpartum emotional distress. Methods: In a prospective longitudinal cohort study, 154 pregnant adolescents (age 14–19) from 10 public clinics were interviewed four times from the third trimester of pregnancy to 16 months postpartum. Planned comparisons of four stress groups were used to compare mean scores for measures of feelings about motherhood, infant care, parenting competency, and emotional distress. Results: Adolescent mothers who experienced high prenatal stress and high parenting stress had lower maternal adjustment (i.e., fewer positive feelings about motherhood, less infant care, and low parenting competency) and high postpartum emotional distress. Even when compared to adolescent mothers who experienced prenatal or parenting stress only, these adolescents were still at a greater disadvantage. Conclusions: Results suggest that adolescents who experience high stress during and after pregnancy are at increased risk for difficult maternal adjustment and high postpartum emotional distress. Findings support the need for health services targeting this subgroup of adolescent mothers, including both prenatal and parenting support. Early intervention to increase maternal adjustment and decrease emotional distress should remain a priority in facilitating the most optimal maternal and child health outcomes.


Adolescents Pregnancy Stress Maternal adjustment 


  1. 1.
    Luoma I, Tamminen T, Kaukonen P, Laippala P, Puura K, Salmelin R et al. Longitudinal study of materal depressive symptoms and child well being. J Am Acad Child Adolesc Pyschiatry 2001;40:1367–74.CrossRefGoogle Scholar
  2. 2.
    Matthey S, Kavanagh DJ, Howie P et al. Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes. J Affect Disord 2004;79: 113–26.PubMedCrossRefGoogle Scholar
  3. 3.
    Passino AW, Whitman TL. Personal adjustment during pregnancy and adolescent parenting. Adolescence 1993;28:97–122.PubMedGoogle Scholar
  4. 4.
    Hess CR, Papas MA, Black, MM. Resilience among African American adolescent mothers: predictors of positive parenting in early infancy. J Pediatr Psych 2002;27:619–29.CrossRefGoogle Scholar
  5. 5.
    Moore MR, Brooks-Gunn J. Adolescent parenthood. Handbook of parenting. Mahwah, New Jersey, Erlbaum, 2002:3.Google Scholar
  6. 6.
    Milan S, Ickovics JR, Kershaw T et al. Prevalence, course, and predictors of emotional distress in pregnant and parenting adolescents. J Coun Clin Psych 2004;72:328–40.CrossRefGoogle Scholar
  7. 7.
    Lobel M, DeVincent CJ, Kaminer A et al. The impact of prenatal maternal stress and optimistic disposition on birth outcomes in medically high-risk women. Health Psych 2000;19:544–53.CrossRefGoogle Scholar
  8. 8.
    Wadhwa PD, Culhane JF, Rauh VR et al. Stress and preterm birth: neuroendocrine, immune/inflammatory, and vascular mechanisms. Matern Child Health J 2001;5:119–25.PubMedCrossRefGoogle Scholar
  9. 9.
    Huizink AC, Robles de Medina PG, Mulder EJ et al. Psychological measures of prenatal stress as predictors of infant temperament. J Am Acad Child Adolesc Psychiatry 2002;41:1078–85.PubMedCrossRefGoogle Scholar
  10. 10.
    Huizink AC, Robles de Medina PG, Mulder EJ et al. Stress during pregnancy is associated with developmental outcome in infancy. J Child Psych Psychiatry 2003;44:810–18.CrossRefGoogle Scholar
  11. 11.
    Glover V, O’Connor TG. Effects of antenatal stress and anxiety. Br J Psychiatry 2002;180:389–91.PubMedCrossRefGoogle Scholar
  12. 12.
    Siddiqui A, Hägglöf B.Does maternal prenatal attachment predict postnatal mother-infant interaction? Early Human Dev 2000;59:3–25.CrossRefGoogle Scholar
  13. 13.
    Britton HL, Gronwaldt V, Britton JR. Maternal postpartum behaviors and mother-infant relationship during the first year of life. J Pediatr 2001;138:905–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Roesch SC, Schetter CD, Woo G et al. Modeling the types and timing of stress in pregnancy. Anxiety Stress Coping 2004;17:87–102.CrossRefGoogle Scholar
  15. 15.
    Centers for Disease Control and Prevention. Birth: Final Data for 2002. National Vital Statistics and Reports, 2003;52.Google Scholar
  16. 16.
    Ickovics JR, Niccolai LM, Lewis JB et al. High postpartum rates of STDs among teens: Pregnancy as a window of opportunity for prevention. Sex Trans Infect 2003;79:469–73.CrossRefGoogle Scholar
  17. 17.
    Niccolai LM, Ethier KA, Kershaw TS et al. Pregnant adolescents at risk: Sexual behaviors and sexually transmitted disease prevalence. Am J Obst Gynecol 2003;188:63–70.CrossRefGoogle Scholar
  18. 18.
    Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385–96.PubMedCrossRefGoogle Scholar
  19. 19.
    Abidin R. Parenting Stress Index Short Form-Test manual. Charlottesville. Virginia: Pediatric Psychology Press, 1990.Google Scholar
  20. 20.
    Johnson C, Mash EJ. A measure of parenting satisfaction and efficacy. J Clin Child Psych 1989;18:167–75.CrossRefGoogle Scholar
  21. 21.
    Derogatis L. Brief Symptom Inventory (BSI): Administration, scoring, and, procedures manual. Minneapolis, Minnesota: NCS Pearson, 1993.Google Scholar
  22. 22.
    Diego MA, Field T, Hernandez-Reif M et al. Prepartum, postpartum, and chronic depression effects on newborns. Psychiatry 2004;67:63–80.PubMedGoogle Scholar
  23. 23.
    Bor W, Brennan PA, Williams GM et al. A mother’s attitude towards her infant and child behaviour five years later. Aust N Z J Psychiatry 2003;37:748–55.PubMedCrossRefGoogle Scholar
  24. 24.
    Barlow J, Coren E. Parent-training programmes for improving maternal psychosocial health, Cochrane Database of Systematic Reviews,CD002020, 2004:1.Google Scholar
  25. 25.
    Maxted AE, Dickstein S, Miller-Loncar C et al. Infant colic and maternal depression. Infant Mental Health J 2005;26:56–68.CrossRefGoogle Scholar
  26. 26.
    Van Doesum K, Hosman C, Riksen-Walraven JM. A model-based intervention for depressed mothers and their infants. Infant Mental Health J 2005;26:157–76.CrossRefGoogle Scholar
  27. 27.
    Flynn L. The adolescent parenting program: Improving outcomes through mentorship. Public Health Nurs 1999;16(3):182–89.PubMedCrossRefGoogle Scholar
  28. 28.
    Sadler LS, Cowlin A. Adolescent mothers combining parent education with creative physical activity. J Specialists Pediatr Nurs 2003;8(2):62–70.CrossRefGoogle Scholar
  29. 29.
    Sangalang BB, Rounds K. Differences in health behaviors and parenting knowledge between pregnant adolescents and parenting adolescents. Soc Work Health Care 2005;42:21-22.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Christina K. Holub
    • 1
  • Trace S. Kershaw
    • 2
  • Kathleen A. Ethier
    • 3
  • Jessica B. Lewis
    • 2
  • Stephanie Milan
    • 4
  • Jeannette R. Ickovics
    • 2
  1. 1.School of Public Health, Department of Health Behavior and Health EducationUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of Epidemiology and Public Health and Center for Interdisciplinary Research on AIDSYale UniversityNew HavenUSA
  3. 3.Centers for Disease Control and Prevention, Division of STD PreventionBehavioral Interventions and Research BranchAtlantaUSA
  4. 4.Department of PsychologyUniversity of ConnecticutStorrsUSA

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