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Prevalence of stressful life events during pregnancy and its association with postpartum depressive symptoms

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Abstract

Experiencing stressful life events (SLEs) has negative consequences for both mother and infant. This study examined the predictive contributions of (1) experiences of each SLE separately and its association with postpartum depressive symptoms (PDS), (2) experiences of cumulative number of SLEs and PDS, and (3) the cumulative experiences of SLEs across three domains (relational, financial, physical health). Georgia’s Pregnancy Risk Assessment Monitoring System data were obtained from 2004 to 2011. Chi-square tests and a combination of weighted logistic regression models were conducted to predict self-reported PDS. Odds ratios (OR) and 95 % confidence intervals (CI) were reported. A total of 10,231 women were included in the analysis; 15 % of the mothers reported PDS. Arguments with partner, trouble paying bills, and separation/divorce significantly predicted increased odds of PDS. Increased odds of PDS were observed with increasing numbers of cumulative SLEs. Experiencing high stress in any domain significantly predicted PDS with the highest predictor being high stress across all domains, followed by experiencing a combination of high relational and financial stress. SLEs were associated with reporting PDS among new mothers in Georgia. It is important to assess for SLEs during prenatal care and provide resources aimed at reducing the impact of SLEs.

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References

  • Ahluwalia IB, Merritt R, Beck LF, Rogers M (2001) Multiple lifestyle and psychological risks and delivery of small for gestational age infants. Obstet Gynecol 97:649–656

    CAS  PubMed  Google Scholar 

  • Alio AP, Mbah AK, Kornosky JL, Wathington D, Marty PJ, Salihu HM (2011) Assessing the impact of paternal involvement on racial/ethnic disparities in infant mortality rates. J Community Health 36:63–68

    Article  PubMed  Google Scholar 

  • Beddoe AE, Yang CP, Kennedy HP, Weiss SJ, Lee KA (2009) The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress. J Obstet Gynecol Neonatal Nurs 38:310–319

    Article  PubMed  Google Scholar 

  • Berg AO (2002) Screening for depression: recommendations and rationale. Am J Nurs 102:77–80

    PubMed  Google Scholar 

  • Brett K, Barfield W, Williams C (2008) Prevalence of self-reported postpartum depressive symptoms—17 states, 2004–2005. Morb Mortal Wkly Rep 57:361–366

    Google Scholar 

  • Broussard DL, Sappenfield WM, Goodman DA (2012) The Black and White of infant back sleeping and infant bed sharing in Florida, 2004–2005. Matern Child Health J 16:713–724

    Article  PubMed  Google Scholar 

  • Burns ER, Farr SL, Howards PP (2015) Stressful life events experienced by women in the year before their infants’ births–United States, 2000–2010. Morb Mortal Wkly Rep 64:247–251

    Google Scholar 

  • Centers for Disease and Prevention (2015) Preconception health indicators. http://www.cdc.gov/prams/pramstat/pdfs/about/chart_domain-mental-health_pramstat-final.pdf

  • Centers for Disease Control and Prevention (2014) Pregnancy Risk Assessment Monitoring System www.cdc.gov/PRAMS/

  • Centers for Disease Control and Prevention (2015) PRAMStat PRAMS Data Query System http://nccd.cdc.gov/PRAMStat/

  • Cheng D, Schwarz EB, Douglas E, Horon I (2009) Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception 79:194–198

    Article  PubMed  Google Scholar 

  • Cowan PA, Cowan CP, Knox V (2010) Marriage and fatherhood programs. Future Child 20:205–230

    Article  PubMed  Google Scholar 

  • Davis K, Pearlstein T, Stuart S, O’Hara M, Zlotnick C (2013) Analysis of brief screening tools for the detection of postpartum depression: comparisons of the PRAMS 6-item instrument, PHQ-9, and structured interviews. Arch Womens Ment Health 16:271–277

    Article  PubMed  PubMed Central  Google Scholar 

  • Duncan LG, Bardacke N (2010) Mindfulness-based childbirth and parenting education: promoting family mindfulness during the perinatal period. J Child Fam Stud 19:190–202

    Article  PubMed  Google Scholar 

  • Fellenzer JL, Cibula DA (2014) Intendedness of pregnancy and other predictive factors for symptoms of prenatal depression in a population-based study. Matern Child Health J 18:2426–2436

    Article  PubMed  Google Scholar 

  • Fisher C, Hauck Y, Bayes S, Byrne J (2012) Participant experiences of mindfulness-based childbirth education: a qualitative study. BMC Pregnancy Childbirth 12:126

    Article  PubMed  PubMed Central  Google Scholar 

  • Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083

    Article  PubMed  Google Scholar 

  • Geronimus AT (1992) The weathering hypothesis and the health of African-American women and infants: evidence and speculations. Ethn Dis 2:207–221

    CAS  PubMed  Google Scholar 

  • Gilbert BC, Shulman HB, Fischer LA, Rogers MM (1999) The Pregnancy Risk Assessment Monitoring System (PRAMS): methods and 1996 response rates from 11 states. Matern Child Health J 3:199–209

    Article  CAS  PubMed  Google Scholar 

  • Gross KH, Wells CS, Radigan-Garcia A, Dietz PM (2002) Correlates of self-reports of being very depressed in the months after delivery: results from the Pregnancy Risk Assessment Monitoring System. Matern Child Health J 6:247–253

    Article  PubMed  Google Scholar 

  • Health Resources and Services Administration (2015) Find shortage areas: medically underserved areas/populations by State and County http://muafind.hrsa.gov/

  • Humbert L, Saywell RM, Zollinger T, Priest CF, Reger MK, Kochhar K (2011) The effect of pregnancy intention on important maternal behaviors and satisfaction with care in a socially and economically at-risk population. Matern Child Health J 15:1055–1066

    Article  PubMed  Google Scholar 

  • Ickovics JR, Reed E, Magriples U, Westdahl C, Schindler Rising S, Kershaw TS (2011) Effects of group prenatal care on psychosocial risk in pregnancy: results from a randomised controlled trial. Psychol Health 26:235–250

    Article  PubMed  PubMed Central  Google Scholar 

  • Krans EE, Moloci NM, Housey MT, Davis MM (2014) Impact of psychosocial risk factors on prenatal care delivery: a national provider survey. Matern Child Health J 18:2362–2370

    Article  PubMed  PubMed Central  Google Scholar 

  • Latendresse G, Wong B, Dyer J, Wilson B, Baksh L, Hogue C (2015) Duration of maternal stress and depression: predictors of newborn admission to Neonatal Intensive Care Unit and Postpartum Depression. Nurs Res 64:331–341

    Article  PubMed  Google Scholar 

  • Liu CH, Tronick E (2013) Re-conceptualising prenatal life stressors in predicting post-partum depression: cumulative-, specific-, and domain-specific approaches to calculating risk. Paediatr Perinat Epidemiol 27:481–490

    Article  PubMed  Google Scholar 

  • Liu CH, Giallo R, Doan SN, Seidman LJ, Tronick E (2016) Racial and ethnic differences in prenatal life stress and postpartum depression symptoms. Arch Psychiatr Nurs 30:7–12

    Article  CAS  PubMed  Google Scholar 

  • Lu MC, Chen B (2004) Racial and ethnic disparities in preterm birth: the role of stressful life events. Am J Obstet Gynecol 191:691–699

    Article  PubMed  Google Scholar 

  • Lu MC, Halfon N (2003) Racial and ethnic disparities in birth outcomes: a life-course perspective. Matern Child Health J 7:13–30

    Article  PubMed  Google Scholar 

  • Lu MC, Jones L, Bond MJ, Wright K, Pumpuang M, Maidenberg M et al (2010) Where is the F in MCH? Father involvement in African American families. Ethn Dis 20:s2-49-61

  • Matthews L (2005) MCH update. NGA Center for Best Practices

  • Mazul M, Salm Ward TC, Ngui EM (2016) Anatomy of good prenatal care: perspectives of low income African-American women on barriers and facilitators to prenatal care. J Racial Ethn Health Disparities. doi:10.1007/s40615-015-0204-x

    PubMed  Google Scholar 

  • National Women’s Law Center (2010) Women and Medicaid in Georgia. National Women’s Law Center, Washington, D.C

    Google Scholar 

  • Nkansah-Amankra S (2010) Neighborhood contextual factors, maternal smoking, and birth outcomes: multilevel analysis of the South Carolina PRAMS Survey, 2000–2003. J Womens Health 19:1543–1552

    Article  Google Scholar 

  • Nkansah-Amankra S, Luchok KJ, Hussey JR, Watkins K, Liu X (2010) Effects of maternal stress on low birth weight and preterm birth outcomes across neighborhoods of South Carolina, 2000-2003. Matern Child Health J 14(2):215–226

  • O’Hara MW, Swain AM (1996) Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry 8:37–54

    Article  Google Scholar 

  • O’Hara MW, Stuart S, Watson D, Dietz PM, Farr SL, D’Angelo D (2012) Brief scales to detect postpartum depression and anxiety symptoms. J Womens Health 21:1237–1243

    Article  Google Scholar 

  • Salm Ward TC, Robb SW, Kanu FA (2016) Prevalence and characteristis of bed-sharing among Black and White infants in Georgia. Matern Child Health J 20:347–362

  • Schindler Rising S (1998) Centering pregnancy: an interdisciplinary model of empowerment. J Nurse Midwifery 43:46–54

    Article  Google Scholar 

  • Shapiro GD, Fraser WD, Frasch MG, Séguin JR (2013) Psychosocial stress in pregnancy and preterm birth: associations and mechanisms. J Perinat Med 41:631–645

    Article  PubMed  PubMed Central  Google Scholar 

  • Stone SL, Hafsatou D, Declercq E, Cabral HJ, Fox MP, Wise LA (2015) Stressful events during pregnancy and postpartum depressive symptoms. J Womens Health 24:384–393

    Article  Google Scholar 

  • Vieten C, Astin J (2008) Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Arch Womens Ment Health 11:67–74

    Article  CAS  PubMed  Google Scholar 

  • Warner RM (2008) Applied statistics: from bivariate through multivariate techniques. SAGE Publications, Los Angeles

    Google Scholar 

  • Whitehead NS, Brogan DJ, Blackmore-Prince C, Hill HA (2003) Correlates of experiencing life events just before or during pregnancy. J Psychom Obstet Gynecol 24:77–86

    Article  CAS  Google Scholar 

  • Whooley MA, Avins AL, Miranda J, Browner WS (1997) Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 12:439–445

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Witt WP, Litzelman K, Cheng ER, Wakeel F, Barker ES (2014) Measuring stress before and during pregnancy: a review of population-based studies of obstetric outcomes. Matern Child Health J 18:52–63

    Article  PubMed  Google Scholar 

  • Woolhouse H, Mercuri K, Judd F, Brown SJ (2014) Antenatal mindfulness intervention to reduce depression, anxiety and stress: a pilot randomized controlled trial of the MindBabyBody program in an Australian tertiary maternity hospital. BMC Pregnancy Childbirth 14:369

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

Georgia Pregnancy Risk Assessment Monitoring System (PRAMS) data were collected and provided by the PRAMS Project in the Maternal and Child Epidemiology Section of the Georgia Department of Public Health (GDPH). The Centers for Disease Control and Prevention Cooperative Agreement grant number UR6/DP000508 provided funding to GDPH for data collection and some staff support. We also acknowledge The PRAMS Working Group.

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Correspondence to Trina Salm Ward.

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Salm Ward, T., Kanu, F.A. & Robb, S.W. Prevalence of stressful life events during pregnancy and its association with postpartum depressive symptoms. Arch Womens Ment Health 20, 161–171 (2017). https://doi.org/10.1007/s00737-016-0689-2

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