Prevalence and Trends of Stressful Life Events among Pregnant Women 2000-2010 Open Access

Burns, Elizabeth Rose (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/q237hs730?locale=en
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Abstract

Stress is associated with poor health outcomes and may partially explain adverse birth outcomes among women with no known risk factors. Previous research has suggested an association between prenatal stress and adverse birth outcomes, such as preterm birth and low birth weight, as well as peripartum anxiety and depression. Prevalence and trends in prenatal stressful life events (SLE) are useful information for clinicians in order to understand the risk profile of their patients. We calculated the prevalence and trends of thirteen SLE experienced in the 12 months prior to a live birth using self-reported data from 180,902 women delivering a live birth in 10 states participating in the 2000-2010 Pregnancy Risk Assessment Monitoring System (PRAMS). Linear and logistic regression models to assess trends over time were adjusted for maternal race/ethnicity, age, and education, marital status, and Medicaid use for prenatal care or delivery. Using chi-square tests, we calculated differences in prevalence estimates for SLEs by maternal demographic characteristics and state of residence for 36,891 women delivering live births in 26 states in 2010. We examined individual SLEs, 4 stress constructs (financial, emotional, traumatic, and partner-related), the presence of one or more SLEs, and mean number of SLEs. In unadjusted and adjusted models, we found that the prevalence of any SLE, all four constructs, and mean number of SLEs decreased slightly between 2000 and 2010 (p<0.05 for all). Twelve of 13 individual SLEs also decreased after adjusting for maternal demographics (p<0.05). Over 70% of women delivering a live birth in 2010 reported experiencing one or more SLEs, with financial SLEs the most commonly reported (51%). In 2010, report of SLEs varied by state and demographic characteristics, with women in Oklahoma and West Virginia, younger women, less educated women, unmarried women, and women covered by Medicaid reporting the highest number of SLEs (p<0.05 for all). Given the high prevalence of SLEs during pregnancy and their association with adverse pregnancy outcomes, clinical and public health interventions are needed to identify and mitigate prenatal stress when an SLE occurs.

Table of Contents

Chapter 1: Background of Stress and its Relationship with Adverse Pregnancy Outcomes ........................................................................................................................1 Literature Review............................................................................................................. 11 Chapter 2: Prevalence and Trends of Stressful Life Events among Pregnant Women 2000-2010......20 Introduction....................................................................................................................20 Methods..........................................................................................................................21 Results...........................................................................................................................24 Discussion.......................................................................................................................27 References......................................................................................................................31 Tables and Figures............................................................................................................ 35

Appendix A. IRB Letter of Exemption...................................................................................41

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