Multiple Lifestyle and Psychosocial Risks and Delivery of Small for Gestational Age Infants

Ahluwalia, Indu B.; MERRITT, ROB; Beck, Laurie F.; Rogers, Mary Moussa

doi:10.1097/00006250-200105000-00002

Cited by 26 publications

(29 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We created a single binary (yes/no) variable for experiencing any of the remaining 12 stressful events. We also grouped the 12 stressful events into 4 categories based on the work of Ahluwalia 36 and utilized in the PRAMS 2008 CDC report: 37 partner-related (questions numbers 1, 3, 4); traumatic (2, 5, 6, and 11); financial (8-10); and emotional (12)(13), with ''no reported stressors'' as our reference.…”

Section: Exposuresmentioning

confidence: 99%

Stressful Events During Pregnancy and Postpartum Depressive Symptoms

Stone

Diop²,

Declercq³

et al. 2015

Journal of Women's Health

View full text Add to dashboard Cite

Background: Understanding the influence of perinatal stressors on the prevalence of postpartum depressive symptoms (PDS) and help-seeking for PDS using surveillance data can inform service provision and improve health outcomes. Methods: We used Massachusetts Pregnancy Risk Assessment Monitoring System (MA-PRAMS) 2007-2010 data to evaluate associations between selected perinatal stressors and PDS and with subsequent help-seeking behaviors. We categorized 12 stressors into 4 groups: partner, traumatic, financial, and emotional. We defined PDS as reporting ''always'' or ''often'' to any depressive symptoms on PRAMS Phase 5, or to a composite score ‡ 10 on PRAMS Phase 6 depression questions, compared with women reporting ''sometimes,'' ''rarely'' or ''never'' to all depressive symptoms. The median response time to MA-PRAMS survey was 3.2 months (interquartile range, 2.9-4.0 months). We estimated prevalence ratios (PRs) and 95% confidence intervals (95% CIs) using modified Poisson regression models, controlling for socioeconomic status indicators, pregnancy intention and prior mental health visits. Results: Among 5,395 participants, 58% reported ‡ 1 stressor (partner = 26%, traumatic = 16%, financial = 29% and emotional = 30%). Reporting of ‡ 1 stressor was associated with increased prevalence of PDS (PR = 1.68, 95% CI: 1.42-1.98). The strongest association was observed for partner stress (PR = 1.90, 95% CI: 1.51-2.38). Thirty-eight percent of mothers with PDS sought help. Mothers with partner-related stressors were less likely to seek help, compared with mothers with other grouped stressors. Conclusions: Women who reported perinatal common stressors-particularly partner-related stressors-had an increased prevalence of PDS. These data suggest that women should be routinely screened during pregnancy for a range of stressors and encouraged to seek help for PDS.

show abstract

Section: Exposuresmentioning

confidence: 99%

Stressful Events During Pregnancy and Postpartum Depressive Symptoms

Stone

Diop²,

Declercq³

et al. 2015

Journal of Women's Health

View full text Add to dashboard Cite

show abstract

“…9 Using a slightly different measure of stress, Ahluwalia et al found an association between multiple psychosocial and lifestyle risks and small-for-gestational-age birth, but the predominant risk was smoking during pregnancy. 24 None of the four (emotional, financial, partner-related, and traumatic) types of stress studied was independently related to small-for-gestational-age birth. Lu and Chen examined the association between these four stress constructs and preterm delivery and found they were not associated with preterm delivery and did not contribute to racial disparities in preterm delivery.…”

Section: Source: Pregnancy Risk Assessment Monitoring Systemmentioning

confidence: 92%

“…That study found that women who experienced multiple risk factors were more likely to deliver a small-for-gestational-age infant, although the association was driven primarily by the woman's smoking behavior. 24 In a previous analysis of these data, I and others found an inconsistent relationship between the number of life events women experienced and the risk of preterm delivery between two cohorts. 9 In the 1990-1993 birth cohort, multiparous women who experienced five or more stressful life events were more likely to deliver preterm, but there was no association among primiparous women.…”

Section: Introductionmentioning

confidence: 95%

The relationship between individual life events and preterm delivery

Whitehead¹

2008

View full text Add to dashboard Cite

Stressful life events have been associated with preterm delivery in some studies but not in others. One cause of this inconsistency may be that different life events have different effects. The author used data collected by the Pregnancy Risk Assessment Monitoring System, a survey of American women with a recent live birth, for 1990–1995 to examine the relationship between individual life events and the risk of preterm delivery overall and by levels of severity. Four events of the 18 examined were associated with an increased risk of at least one category of preterm delivery: being in debt, being injured by a partner, having someone close attempt suicide, and being divorced. Women who reported being in debt had an increased risk of preterm delivery overall and for each level of severity. One event, having a partner who lost his (or her) job, was associated with a decreased risk of preterm delivery. These results provide some support for the theory that increased stress from life events causes preterm delivery. The lack of a pattern by type of stress, expected stressfulness, or severity of prematurity are hard to reconcile with those theories, however.

show abstract

“…Newly acquired fatigue, physical pain and discomfort, and emotional irregularity greatly impact one's ability to cope with environmental stressors and engage in health promotion behaviors [16][17][18] . When combined with the intimate and invasive nature of perinatal care, it is no wonder that this time period may be traumatic and potentially triggering for survivors of IPV 19,20 -particularly those with symptomatology of depression, anxiety or PTSD 8,12,21 .…”

Section: Introductionmentioning

confidence: 99%

Examining the Impact of Trauma-Informed Cognitive Behavioral Therapy on Perinatal Mental Health Outcomes Among Survivors of Intimate Partner Violence (The PATH Study): Protocol for a Feasibility Study (Preprint)

Jackson¹,

Parkinson²,

Jackson³

et al. 2018

Preprint

View full text Add to dashboard Cite

BACKGROUND Intimate partner violence (IPV) is a pervasive public health problem, impacting the health and quality of life of survivors worldwide. The trauma of IPV is associated with a high incidence of mental illness, namely depressive and anxiety disorders, and posttraumatic stress disorder (PTSD). Moreover, literature endorses cognitive behavioral therapy (CBT) interventions as a gold standard for those with symptomatology consistent with anxiety disorders, mood disorders, and PTSD. However, efficacy has not been evaluated among a population of pregnant survivors of IPV. OBJECTIVE We present the protocol that will be used to explore the efficacy of trauma-informed cognitive behavioral therapy on maternal and child health outcomes for pregnant women with PTSD, depression, or anxiety symptomatology resulting from IPV. A secondary aim will be to test the validity and feasibility of study methodology to support the successful implementation of a full-scale randomized controlled trial. METHODS The Promoting Attachment Through Healing (PATH) study will use a mixed-methods approach grounded in an intersectional feminist framework to explore the effectiveness of trauma-informed CBT for pregnant survivors of IPV. Study participants will be recruited through the hospital-based Perinatal Mental Health Clinic (London, Ontario, Canada). A feasibility sample of 20 pregnant women (cohort 1) will be selected to engage in an eight-session antenatal CBT intervention facilitated by the program’s perinatal clinical nurse specialist, with evaluation at baseline, at two months postpartum (intervention and online questionnaire), and at six and twelve months postpartum (online questionnaire only). Concurrently, we will conduct a retrospective audit of 100 medical charts (cohort 2; 50 charts of perinatal women who received CBT and 50 charts of women who did not receive perinatal CBT) from the past five years. The efficacy of the intervention will be based on a reduction of mental illness symptomatology, improved maternal-infant attachment, maternal coping, and maternal quality of life. Additionally, the feasibility of the protocol and acceptability of the intervention from the women’s perspective will be examined. Inductive content analysis of all qualitative data will be used to determine common themes. Additionally, descriptive statistics, including measures of central tendency and dispersion, will be computed for all continuous variables. Alternatively, frequency tables will be constructed for all categorical variables. RESULTS The work reported here is in the proposal phase. Once the protocol is implemented, we will report the results in a follow-up paper. Participant recruitment for cohort 1 has started and we have finished data collection for cohort 2. It is anticipated that the results will be available by the end of 2018. CONCLUSIONS Findings will assess the acceptability of the study methodology and protocol for a full-scale randomized controlled trial. Furthermore, if CBT is proven effective for pregnant survivors of IPV, this intervention could be readily adopted by health care and social support services, thereby contributing to an improved standard of care for this unique population. CLINICALTRIAL ClinicalTrials.gov NCT03536442; https://www.clinicaltrials.gov/ct2/show/NCT03536442 (Archived by WebCite at http://www.webcitation.org/6zeurv1ay) REGISTERED REPORT IDENTIFIER RR1-10.2196/9820

show abstract

Multiple Lifestyle and Psychosocial Risks and Delivery of Small for Gestational Age Infants

Cited by 26 publications

References 30 publications

Stressful Events During Pregnancy and Postpartum Depressive Symptoms

Stressful Events During Pregnancy and Postpartum Depressive Symptoms

The relationship between individual life events and preterm delivery

Examining the Impact of Trauma-Informed Cognitive Behavioral Therapy on Perinatal Mental Health Outcomes Among Survivors of Intimate Partner Violence (The PATH Study): Protocol for a Feasibility Study (Preprint)

Contact Info

Product

Resources

About