Predictors of psychological distress in low‐income mothers over the first postpartum year

Abstract

Up to 25% of postpartum women experience psychological distress including stress, depressive, or anxiety symptoms during the postpartum period. The purpose of this study was to explore the extent to which social determinants of health and allostatic load score, a 10‐item index of biologic measures of chronic stress, predict psychological distress in low‐income pregnant women over the first postpartum year. We conducted a secondary data analysis of the Child Community Health Research Network data set. The psychological distress outcome variables were perceived stress (n = 842), depression ( n = 845), and anxiety ( n = 846) symptoms, all measured categorically over the first year postpartum (T1:1 month, T2: 24–29 weeks, and T3: 50–65 weeks). Our predictors were social determinants of health (e.g., demographics, maternal hardship, percent poverty level, interpersonal violence, and food security) and allostatic load score. Generalized linear mixed models were used to determine which predictors were significantly associated with psychological distress symptoms across the first postpartum year. Interpersonal violence was a statistically significant risk factor for stress, depression, and anxiety symptoms over the first year postpartum. Other significant risk factors included low‐income level, nativity, and perceived food security. Receiving food stamps was a significant protective factor for stress symptoms. The significance of risk factors for psychological distress, both modifiable and nonmodifiable, can be used as potential targets for further research, screening, and intervention. Future work should explore why and in what conditions these risk factors vary over time.

The Lived Experience of Postpartum Women Attending Outpatient Substance Treatment for Opioid or Heroin Use

“…The tandem presence of anxiety in postpartum women with OUD has been previously reported 8,26 ; however, the associated of mental health issues and fear of being reported to child protective services warrants further exploration. Previous research finding suggests that psychological distress induced by a modifiable risk factor in the first year postpartum can be lessened by providing targeted interventions designed to minimize the effects of a trigger and decrease the burden of a negative outcome 11 …”

“…For childbearing women with OUD, the postpartum period represents a time of increased vulnerabilities. In addition to the need for a woman's physical recovery, adaption to parenthood, and learning how to breastfeed, 7 postpartum women with OUD have an elevated risk of being diagnosed with a behavioral health disorder (depression, anxiety), 8 intimate partner violence (IPV), 9,10 social adversity (poverty, food insecurity), 11 or substance use relapse 12 . In fact, women with OUD overdose more frequently in the postpartum period when compared with pregnancy; the highest rate occurring at 7 to 12 months postpartum 13 .…”

Allostatic Load and Its Impact on Health: A Systematic Review

“…Several studies showed a significant association be tween depressive and anxiety symptoms and allostatic Psychother Psychosom 2021;90:11-27 DOI: 10.1159/000510696 load [279][280][281][282][283], not confirmed by others [233,[284][285][286]. In the association between childhood physical abuse and depression in adulthood, allostatic load appeared to have a mediating role [287].…”

Maternal Prenatal Hair Cortisol Is Associated with Child Wheeze among Mothers and Infants with Tobacco Smoke Exposure and Who Face High Socioeconomic Adversity

“…In total, 64% of mothers in our sample reported depression or anxiety and this was not associated with wheeze. Identifying the prevalence of prenatal depression and anxiety nationally is challenging, although the evidence suggests that approximately 25% of women report psychological distress including depression or anxiety during pregnancy [ 17 ]. A relationship between depression and anxiety and wheeze may have been washed out due to the high prevalence of depression and anxiety in this sample or bias in self-reporting.…”

“…Reporting just 1–2 life stressors increased the probability of smoking by 6% relative to reporting no life stressors [ 16 ]. In general, women with low income and low educational attainment are at increased risk for reporting perinatal stressful life events, psychological stress and correlates of stress, and depression and anxiety [ 17 , 18 ].…”