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Maternal and Child Health Journal

, Volume 20, Issue 6, pp 1103–1113 | Cite as

A Multidimensional Approach to Characterizing Psychosocial Health During Pregnancy

  • Pamela J. MaxsonEmail author
  • Sharon E. Edwards
  • Ellis M. Valentiner
  • Marie Lynn Miranda
Article

Abstract

Objectives Domains of psychosocial health have been separately connected to pregnancy outcomes. This study explores the relationship between five domains of psychosocial health and their joint association with prenatal health and pregnancy outcomes. Methods Women from a prospective cohort study in Durham, North Carolina were clustered based on measures of paternal support, perceived stress, social support, depression, and self-efficacy. Clusters were constructed using the K-means algorithm. We examined associations between psychosocial health and maternal health correlates, pregnancy intention, and pregnancy outcomes using Chi square tests and multivariable models. Results Three psychosocial health profiles were identified, with the first (Resilient; n = 509) characterized by low depression and perceived stress and high interpersonal support, paternal support, and self-efficacy. The second profile (Vulnerable; n = 278) was marked by high depression and perceived stress, and low interpersonal support, paternal support, and self-efficacy. The third profile (Moderate, n = 526) fell between the other profiles on all domains. Health correlates, pregnancy intention, and pregnancy outcomes varied significantly across profiles. Women with the vulnerable profile were more likely to have risky health correlates, have an unintended pregnancy, and deliver preterm. Women with the resilient profile had better birth outcomes and fewer deleterious health correlates, preconception and prenatally. Conclusions We posit that vulnerable psychosocial health, deleterious health correlates, and the stress which often accompanies pregnancy may interact to magnify risk during pregnancy. Identifying and intervening with women experiencing vulnerable psychosocial health may improve outcomes for women and their children.

Keywords

Psychosocial health Pregnancy outcomes Prenatal health Cluster analysis 

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Pamela J. Maxson
    • 1
    Email author
  • Sharon E. Edwards
    • 1
  • Ellis M. Valentiner
    • 1
  • Marie Lynn Miranda
    • 1
    • 2
    • 3
  1. 1.Children’s Environmental Health Initiative, School of Natural Resources and EnvironmentUniversity of MichiganAnn ArborUSA
  2. 2.Department of Obstetrics and GynecologyUniversity of MichiganAnn ArborUSA
  3. 3.Department of Pediatrics and Communicable DiseasesUniversity of MichiganAnn ArborUSA

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