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

ABSTRACT: 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 2nd 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 (? = 1.63, 95% CI = 0.29, 3.07; ? = 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.

SUBMITTER: Eick SM

PROVIDER: S-EPMC7292353 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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

Eick Stephanie M SM Goin Dana E DE Izano Monika A MA Cushing Lara L DeMicco Erin E Padula Amy M AM Woodruff Tracey J TJ Morello-Frosch Rachel R

PloS one 20200612 6

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 ...[more]

PMID: 32530956

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Project description:BackgroundPerfluoroalkyl substances (PFAS) and polybrominated diphenyl ethers (PBDEs) are used in consumer products for their water repellent and flame retardant properties, respectively. However, there is widespread prenatal exposure and concern about their potential harm to the developing fetus. Here, we utilized data from a demographically diverse cohort of women in San Francisco, CA to examine associations between prenatal exposure to PFAS and PBDEs with gestational age and birth weight for gestational age z-scores.MethodsWomen included in this analysis were enrolled in the Chemicals in our Bodies (CIOB) cohort study (N = 506). PFAS and PBDEs were measured in serum obtained during the second trimester of pregnancy. Linear regression models were used to calculate crude and adjusted β coefficients for the association between PFAS and PBDE concentrations in tertiles and gestational age and birth weight z-scores. Individual PFAS and PBDE concentrations, as well as their sums, were examined in separate models.ResultsThe highest compared to lowest tertile of BDE-47 was associated with shorter gestational age (β = - 0.49, 95% confidence interval [CI] = - 0.95, - 0.02). Additionally, exposure to BDE-47 and BDE-99 in the middle tertile was also associated with a reduction in birth weight z-scores (β = - 0.26, 95% CI = -0.48, - 0.04; β = - 0.25, 95% CI = -0.47, - 0.04, respectively) compared to those in the lowest tertile of exposure. No consistent associations were observed between increasing PFAS concentrations and gestational age or birth weight z-scores.DiscussionAmong a diverse group of pregnant women in the San Francisco Bay Area, we found non-linear associations between prenatal exposure to PBDEs during the second trimester of pregnancy and birth weight z-scores. However, most PFAS congeners were not associated with adverse birth outcomes. PFAS and PBDE concentrations were lower in our cohort relative to other studies. Future research should assess the effects of emerging and persistent PFAS and PBDEs on birth outcomes, as some congeners are being phased out and replaced by chemically similar structures.

Project description:Study objectivesTo examine associations between perceived neighborhood social environment (PNSE) and sleep, mediated by physical activity (PA) and psychosocial stressors.MethodsA sample (n = 4705) of African Americans (mean age 55.0 years; 63.4% female) enrolled in the 2000-2004 Jackson Heart Study (JHS). Four self-reported sleep outcomes were analyzed: sleep duration (minutes/night), sleep quality (high/low), short sleep (short ≤ 6 h vs recommended = 7-8 h), and long sleep (long ≥ 9 h vs recommended). PNSE factors included violence (e.g. robbery), problems (trash/litter), and social cohesion (trusting neighbors). PA and psychosocial stressors (lifetime and everyday discrimination, perceived stress, and depressive symptoms) were tested as mediators. With bootstrap-generated 95% bias-corrected confidence intervals (BC CIs), linear regression was used to test for mediation adjusting for covariates.ResultsNeighborhood violence and problems were associated with sleep duration, mediated through PA (B = -1.97, 95%BC CI = -3.76, -0.60; B = -1.23, 95%BC CI = -2.55, -0.27, respectively), lifetime discrimination (B = 2.61, 95%BC CI = 0.93, 4.80; B = 2.25, 95%BC CI = 0.93, 3.94), perceived stress (B = -3.08, 95%BC CI = -6.20, -0.41; B = -2.17, 95%BC CI = -4.33, -0.28), and depressive symptoms (B = -2.22, 95%BC CI = -5.09, -0.25; B = -1.94, 95%BC CI = -4.10, -0.35). Social cohesion was positively associated with sleep duration, mediated through PA, lifetime discrimination, and perceived stress. Similar patterns were demonstrated for binary outcomes. Yet, effect sizes were relatively small. PNSE was neither directly nor indirectly associated with sleep outcomes by everyday discrimination.ConclusionsEach PNSE factor was associated with sleep outcomes, mediated by PA and psychosocial stressors. Further research should emphasize effective community efforts to decrease adverse neighborhood conditions and psychosocial factors and increase PA; thereby reducing CVD events for African Americans.

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

Publications

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

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