The balance between stress and personal capital during pregnancy and the relationship with adverse obstetric outcomes: findings from the 2007 Los Angeles Mommy and Baby (LAMB) study

Abstract

Purpose Stress during pregnancy is a salient risk factor for adverse obstetric outcomes. Personal capital during pregnancy, defined as internal and social resources that help women cope with or decrease their exposure to stress, may reduce the risk of poor obstetric outcomes. Methods Using data from the 2007 Los Angeles Mommy and Baby (LAMB) survey (N=3,353), we examined the relationships between the balance of stress and personal capital during pregnancy, or the Stress-to-Capital Ratio (SCR), and adverse obstetric outcomes ((i.e., pregnancy complications, preterm birth (PTB), low birthweight (LBW), and small-for-gestational-age (SGA)). Results Women with a higher SCR (i.e. greater stress relative to personal capital during pregnancy) were significantly more likely to experience at least one pregnancy complication, PTB, and lower gestational age, but not LBW or SGA. Accounting for pregnancy complications completely mediated the association between the SCR and PTB. Conclusions Our findings indicate that experiencing greater stress relative to personal capital during pregnancy is associated with an increased risk for pregnancy complications, PTB, and lower gestational age and that pregnancy complications may be a mechanism by which the SCR is related to adverse obstetric outcomes.

Preterm Birth and Social Support during Pregnancy: a Systematic Review and Meta‐Analysis

“…There were two studies that measured the association between social support and PTB among women with high levels of stress and low levels of social support . The first, a prospective study conducted in Canada, recruited women through health care offices, community settings, and lab services offices .…”

Determinants of Cesarean Delivery in the US: A Lifecourse Approach

“…The robust set of maternal predictors and population-based sample supports several important clinical and public health implications. First, our findings suggest that screening women for PSLEs and offering targeted interventions, including interventions that provide women with resources (e.g., mental healthcare) to cope with PSLEs (35), may be instrumental for lowering the risk of having an indicated C-section. Second, as our study provides further evidence that a prior C-section is the strongest predictor of a non-indicated C-section, greater awareness is needed among women and their healthcare providers about the deleterious risks associated with repeat C-sections in order to promote discussion and use of alternative options (e.g., VBAC) when safe and available.…”

Neighborhood Disadvantage, Preconception Stressful Life Events, and Infant Birth Weight

“…This hypothesis suggests that neighborhood conditions might operate as a moderator on the effects of maternal experiences before and during pregnancy on birth outcomes. Specifically, disadvantaged neighborhood conditions might directly affect the amount of resources and stressors that reproductive age women experience, such as limited access to prenatal care, unhealthy behaviors, and poor health conditions, 8,25,27 which all eventually contribute to adverse birth outcomes. Furthermore, disadvantaged neighborhoods might be associated with increased chronic stressors that contribute to deterioration in normal physiological processes, which might be more severe among minority women compared with non-Hispanic White women across the life course.…”