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Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis

Pregnant women who experience psychosocial stressors, such as stressful life events, poor neighborhood quality, and financial hardship, are at an increased risk for adverse pregnancy outcomes. Yet, few studies have examined associations between multiple stressors from different sources, which may be...

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Autores principales: Eick, Stephanie M., Goin, Dana E., Izano, Monika A., Cushing, Lara, DeMicco, Erin, Padula, Amy M., Woodruff, Tracey J., Morello-Frosch, Rachel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292353/
https://www.ncbi.nlm.nih.gov/pubmed/32530956
http://dx.doi.org/10.1371/journal.pone.0234579
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author Eick, Stephanie M.
Goin, Dana E.
Izano, Monika A.
Cushing, Lara
DeMicco, Erin
Padula, Amy M.
Woodruff, Tracey J.
Morello-Frosch, Rachel
author_facet Eick, Stephanie M.
Goin, Dana E.
Izano, Monika A.
Cushing, Lara
DeMicco, Erin
Padula, Amy M.
Woodruff, Tracey J.
Morello-Frosch, Rachel
author_sort Eick, Stephanie M.
collection PubMed
description Pregnant women who experience psychosocial stressors, such as stressful life events, poor neighborhood quality, and financial hardship, are at an increased risk for adverse pregnancy outcomes. Yet, few studies have examined associations between multiple stressors from different sources, which may be helpful to better inform causal pathways leading to adverse birth outcomes. Using path analysis, we examined associations between multiple self-reported stressor exposures during and before pregnancy in the Chemicals in Our Bodies-2 study (N = 510), a demographically diverse cohort of pregnant women in San Francisco. We examined associations between eight self-reported exposures to stressors and three responses to stress which were assessed via interview questionnaire at the 2(nd) trimester. Stressors included: neighborhood quality, stressful life events, caregiving, discrimination, financial strain, job strain, food insecurity, and unplanned pregnancy. Perceived stress, depression, and perceived community status were included as indicators of self-reported stress response. Our model indicated that women who experienced discrimination and food insecurity had a 3.76 (95% confidence interval [CI] = 1.60, 5.85) and 2.67 (95% CI = 1.31, 4.04) increase in depression scale scores compared to women who did not experience discrimination and food insecurity, respectively. We additionally identified job strain and caregiving for an ill family member as strong predictors of increased depressive symptoms (β = 1.63, 95% CI = 0.29, 3.07; β = 1.48, 95% CI = 0.19, 2.70, respectively). Discrimination, food insecurity, and job strain also influenced depression indirectly through the mediating pathway of increasing perceived stress, although indirect effects were less precise. In our study population, women who experienced discrimination, food insecurity, job strain and caregiving for an ill family member had an increased number of depressive symptoms compared to women who did not experience these stressors. Results from our study highlight the complex relationships between stressors and stress responses and may help to identify possible mediating pathways leading to adverse pregnancy outcomes.
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spelling pubmed-72923532020-06-18 Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis Eick, Stephanie M. Goin, Dana E. Izano, Monika A. Cushing, Lara DeMicco, Erin Padula, Amy M. Woodruff, Tracey J. Morello-Frosch, Rachel PLoS One Research Article Pregnant women who experience psychosocial stressors, such as stressful life events, poor neighborhood quality, and financial hardship, are at an increased risk for adverse pregnancy outcomes. Yet, few studies have examined associations between multiple stressors from different sources, which may be helpful to better inform causal pathways leading to adverse birth outcomes. Using path analysis, we examined associations between multiple self-reported stressor exposures during and before pregnancy in the Chemicals in Our Bodies-2 study (N = 510), a demographically diverse cohort of pregnant women in San Francisco. We examined associations between eight self-reported exposures to stressors and three responses to stress which were assessed via interview questionnaire at the 2(nd) trimester. Stressors included: neighborhood quality, stressful life events, caregiving, discrimination, financial strain, job strain, food insecurity, and unplanned pregnancy. Perceived stress, depression, and perceived community status were included as indicators of self-reported stress response. Our model indicated that women who experienced discrimination and food insecurity had a 3.76 (95% confidence interval [CI] = 1.60, 5.85) and 2.67 (95% CI = 1.31, 4.04) increase in depression scale scores compared to women who did not experience discrimination and food insecurity, respectively. We additionally identified job strain and caregiving for an ill family member as strong predictors of increased depressive symptoms (β = 1.63, 95% CI = 0.29, 3.07; β = 1.48, 95% CI = 0.19, 2.70, respectively). Discrimination, food insecurity, and job strain also influenced depression indirectly through the mediating pathway of increasing perceived stress, although indirect effects were less precise. In our study population, women who experienced discrimination, food insecurity, job strain and caregiving for an ill family member had an increased number of depressive symptoms compared to women who did not experience these stressors. Results from our study highlight the complex relationships between stressors and stress responses and may help to identify possible mediating pathways leading to adverse pregnancy outcomes. Public Library of Science 2020-06-12 /pmc/articles/PMC7292353/ /pubmed/32530956 http://dx.doi.org/10.1371/journal.pone.0234579 Text en © 2020 Eick et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Eick, Stephanie M.
Goin, Dana E.
Izano, Monika A.
Cushing, Lara
DeMicco, Erin
Padula, Amy M.
Woodruff, Tracey J.
Morello-Frosch, Rachel
Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis
title Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis
title_full Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis
title_fullStr Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis
title_full_unstemmed Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis
title_short Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis
title_sort relationships between psychosocial stressors among pregnant women in san francisco: a path analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292353/
https://www.ncbi.nlm.nih.gov/pubmed/32530956
http://dx.doi.org/10.1371/journal.pone.0234579
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