Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117872

Michael C. Lu, MD, MPH and Belinda M. Chen, MPH. Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, Box 951772, Los Angeles, CA 90095-1772, (310) 825-5297, mclu@ucla.edu

Objectives: To examine the relation between stressful life events and maternal risk behaviors among U.S. women of different racial-ethnic and socioeconomic backgrounds.

Study Design: Using data from the Pregnancy Risk Assessment Monitoring System (PRAMS), we conducted a retrospective cohort analysis of a sample of 33,542 women from 19 states who delivered a liveborn infant in 2000. Principal component analysis was used to group 13 stressful life events into 4 stress constructs: emotional, financial, partner-related, and traumatic. The relationships between stressful life events and four maternal risk behaviors were examined using bivariate, multivariate and stratified analyses.

Results: Women who reported experiencing financial, partner-related, and traumatic stressors just before and during pregnancy were significantly more likely to smoke cigarettes and start prenatal care after the first trimester. Even after adjusting for sociodemographic differences in the multivariate model, the experience of financial or traumatic stressors was still associated with 25% and 51% increased odds of smoking, respectively, and the experience of financial, partner-related, and traumatic stressors was associated with 21% to 25% increased odds of late entry into prenatal care. The association was particularly strong between these stressors and cigarette smoking for low-SES African American women, and between financial stressors and smoking or late prenatal care for low-SES American Indian/Alaska Natives. The influence of partner-related stressors was particularly strong among Hispanic women.

Conclusion: Stressful life events are associated with increased maternal risk behaviors. Future research needs to consider the social and cultural contexts of maternal risk behaviors.

Learning Objectives: At the conclusion of this session, the participant in this session will be able to

• Describe the relationship between stressful life events before and during pregnancy and maternal risk behaviors (cigarette smoking and late entry into prenatal care).
• Understand the social and cultural contexts of maternal risk behaviors.

Keywords: Stress, Pregnancy

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.