Is prenatal maternal distress context-dependent? Comparing United States and the Netherlands

Abstract

Background: Maternal anxiety and depression symptoms during pregnancy can compromise a woman's wellbeing and affect offspring development. The present study represents a comparison of maternal late-pregnancy internalizing symptoms (i.e., depression and anxiety) between the United States of America (US) and the Netherlands. We hypothesized that women in the US would report higher levels of anxiety and depression during pregnancy compared to their Dutch counterparts, both on individual symptom indicators and overall latent distress, due to more favorable policies/accessible services relevant to perinatal health in the Netherlands. Methods: Pregnant women were recruited at two comparable sites in the Netherlands (n = 327) and the US (n = 228). Measures included self-reports of internalizing distress and key covariates (i.e., parity, gestational, and maternal age). Results: Expectant mothers in the US reported higher depressive and anxiety symptoms compared to their Dutch counterparts. Results were consistent across individual internalizing symptom indicators and the overall latent prenatal distress means computed for US and Dutch samples, with an estimated large effect size for the latter after controlling for covariates. Limitations: Despite their relatively large sizes, our samples were limited in their representativeness of the two cultures and mechanisms contributing to observed differences were not examined. Conclusions: Pregnant women in the US reported higher levels of depression and anxiety symptoms than women in the Netherlands. Implications concern perinatal policy and clinical services (e.g., emotional health support provided to mothers).

Related Psychosocial Factors and Delivery Mode of Depression and Anxiety in Primipara in Late Pregnancy

“…The health status of primiparas and their mental preparation for pregnancy and delivery after pregnancy are also important factors that affect their emotions [ 14 ]. Prepregnancy underlying diseases and/or postpregnancy complications will increase the risk of adverse pregnancy outcomes and have adverse effects on the life and health of both the pregnant woman and the fetus [ 15 ]. In addition, in the early stage of pregnancy, pregnancy reaction can cause nausea, vomiting, loss of appetite, and other early pregnancy reaction [ 16 ].…”

Adolescents’ hair cortisol concentrations during COVID‐19: Evidence from two longitudinal studies in the Netherlands and the United States

“…The findings revealed nonsignificant changes in pandemic HCC in two similar Western samples of low‐risk community children and adolescents, suggesting that psychoneuroendocrine processes unfold similarly even in different contexts when exposed to the same stressor. Our initial hypothesis concerning such differences was based on prior work showing a heightened level of maternal distress in the prenatal period (Gartstein et al., 2020) and more reactive temperament in infants (Sung et al., 2015) in the United States compared to the Netherlands, hinting at different stress processes in similar samples from different contexts. It could be the case that such differences fade with age or that these may manifest at a behavioral but not physiological level, as investigated here.…”

“…Previous studies have shown context‐dependent differences across countries in child cortisol outcomes based on variations in the prenatal and postnatal environment (Desmarais et al., 2021). One study found that pregnant women in the United States experienced heightened levels of psychological distress compared to women in the Netherlands, possibly due to culturally mediated contextual factors, such as less favorable perinatal health care (Gartstein et al., 2020). These findings are significant because perinatal symptoms of anxiety and depression were found to predict altered offspring developmental outcomes, in line with the fetal programming hypothesis (Glover et al., 2018).…”

Development and psychometric evaluation of the High-Risk Pregnancy Well-Being Index in Mashhad: a methodological study

“…Well-being and well-being in HRP are broadly defined as having senses of pleasure, happiness, and satisfaction and consists of physical, functional, emotional, intellectual, psychological, familial, and social aspects [ 11 ]. Well-being improvement and distress reduction during HRP are the keys to achieve positive maternal–fetal outcomes [ 17 – 19 ]. Therefore, besides physical problems, healthcare providers need to pay close attention to the feelings, satisfaction, and well-being of women during HRP and need to employ appropriate interventions to reduce their problems and improve their well-being [ 20 , 21 ].…”