Factors affecting pregnancy and birth outcomes: A holistic approach

Introduction: Wellness during pregnancy is related not only to biophysical characteristics and health behaviors, but also to social interactions, emotional state, and spiritual beliefs. The purpose of this two-phase study was to use a holistic (body-mind-spirit) model to measure the behaviors and characteristics that contribute to a woman's overall wellness during pregnancy and how these factors relate to having a healthy baby.

Method: This was a cohort study of 163 predominately low-income African American women enrolled between 9-36 weeks of pregnancy and followed until delivery. Healthy Start staff collected measures of spirituality, perception of stress, depressive symptoms, number, type, and functionality of the social support network, and the perception of everyday discriminatory experiences. Data were also collected on preexisting health conditions, health risk behaviors, and demographics.

Results: During pregnancy, higher spirituality was associated with higher social support (p=0.029). Covariates such as older age (p=0.039), higher income (p=0.015), and Medicaid status (p=0.024) were more likely to influence spirituality. Lower depressive symptoms and lower perceptions of stress during pregnancy were more likely to be influenced by higher education (p=0.002, p=0.047, respectively). Social support (p=0.007), marital status (p=0.028) and Medicaid (p=0.020) were more likely to influence infant birth weight. Women who were single, on Medicaid, and had higher social support were more likely to have higher birth weight infants.

Conclusions: Higher spirituality and social support were associated with health during pregnancy; increasing spiritual resources and social support services prior to and during pregnancy can potentially improve health promotion efforts for pregnant women.