The Role of Social Support as a Buffer Against Adverse Perinatal Outcomes Among People Experiencing Neighborhood Deprivation and Discrimination Restricted; Files Only
Dixon, Meredith (Fall 2024)
Abstract
The overarching goal of this dissertation was to explore how social support might buffer against the adverse effects of neighborhood deprivation and discrimination on perinatal outcomes.
Aim 1: We examined the degree to which prenatal social support modified the adverse effects of neighborhood deprivation on birth outcomes, including preterm birth, low birthweight, and small for gestational age (SGA). Overall, we saw very small associations between neighborhood deprivation and birth outcomes. Social support appeared to offer very slight protection against the effects of neighborhood deprivation on SGA, particularly for non-Hispanic White people. However, we did not find evidence of social support buffering against the effects of neighborhood deprivation on preterm birth or low birthweight outcomes.
Aim 2: We evaluated the degree to which prenatal social support modified the adverse effects of neighborhood deprivation on hypertensive disorders of pregnancy (HDP), including gestational hypertension and preeclampsia/eclampsia. Overall, we saw very small associations between neighborhood deprivation and HDP. Neighborhood deprivation was associated with increased prevalence of HDP among non-Hispanic Black people, and social support appeared to offer some protection against preeclampsia/eclampsia among non-Hispanic White and Asian people. However, we did not find evidence of social support buffering against the effects of neighborhood deprivation on either gestational hypertension or preeclampsia/eclampsia.
Aim 3: We assessed the degree to which postnatal social support modified the adverse effects of discrimination on postpartum depression. Black participants reported the highest levels of discrimination. Our study underscored the increased prevalence of postpartum depression among people experiencing discrimination, and the decreased prevalence of postpartum depression among people reporting high social support, especially in the first 5 months after delivery. Results also suggested mild buffering by social support against the impact of high levels of discrimination on depression, though not consistently across time or race and ethnicity.
Conclusion: Social support buffering did not appear as important as hypothesized across studies. Even so, this dissertation highlights the reduced prevalence of adverse perinatal outcomes among people reporting high social support and provides more nuanced information about the role of social support during pregnancy and the postpartum period.
Table of Contents
Chapter 1: Overview and Specific Aims 1
Introduction 1
Data Sources 2
Specific Aims 2
Public Health Importance 3
Chapter 2: Background 4
Adverse Birth Outcomes 4
Hypertension During Pregnancy 5
Postpartum Depression 7
Neighborhood Deprivation 8
Discrimination 10
Social Support 11
Literature Review Tables 14
Chapter 3: The Role of Social Support as a Buffer Against Adverse Birth Outcomes Among People Experiencing Neighborhood Deprivation 32
Abstract 32
Introduction 33
Methods 34
Results 37
Discussion 40
Tables and Figures 43
Chapter 4: The Role of Social Support as a Buffer Against Hypertensive Disorders of Pregnancy Among People Experiencing Neighborhood Deprivation 55
Abstract 55
Introduction 56
Methods 57
Results 60
Discussion 63
Tables and Figures 67
Appendix: Blood Pressure Patterns During Pregnancy 82
Chapter 5: The Role of Social Support as a Buffer Against Postpartum Depression Among People Experiencing Discrimination 86
Abstract 86
Introduction 87
Methods 88
Results 91
Discussion 95
Tables and Figures 98
Appendix: Pregnancy Risk Assessment Monitoring System (PRAMS) data 111
Chapter 6: Conclusions, Impact, and Future Research 119
Summary of Findings 119
Strengths and Limitations 121
Potential Impact 122
Future Research Directions 125
References 126
About this Dissertation
| School | |
|---|---|
| Department | |
| Degree | |
| Submission | |
| Language |
|
| Research Field | |
| Palabra Clave | |
| Committee Chair / Thesis Advisor | |
| Committee Members |
Primary PDF
| Thumbnail | Title | Date Uploaded | Actions |
|---|---|---|---|
|
|
File download under embargo until 09 January 2027 | 2024-12-10 21:21:03 -0500 | File download under embargo until 09 January 2027 |
Supplemental Files
| Thumbnail | Title | Date Uploaded | Actions |
|---|