Stress and trauma as predictors of health status and depressive symptoms among low-income pregnant latinas: Implications for screening practice

Background: While depressive symptoms have been extensively studied among pregnant women, few investigations have examined the roles perceived stress and trauma history in health status and depressive symptoms among low-income, ethnic women during early pregnancy. The current prospective study investigated socio-demographic factors (i.e. education, age, poverty index, marriage, employment and birthplace (foreign vs. US born), perceived stress, and trauma history as predictors of health status and depressive symptoms. We also sought to examine the effect of these variables on mental and physical health status separately. Methods: 210 Latinas (mean age = 27.7 years) who were at least twelve-weeks pregnant and attending prenatal clinics in Los Angeles were enrolled. Participants completed structured interviews and self-report measures in English or Spanish. Trauma history was assessed with the Trauma History Questionnaire, perceived stress with the Perceived Stress Scale, health status (physical and mental health) with the short-form survey (SF-12) and depressive symptoms with the CES-D. Hierarchical regressions were used in four separate analyses to examine potential and direct effects of perceived stress and trauma on mental health and physical health status and depressive symptoms separately. Results: Trauma history (â = -.358; p = .0000) was negatively associated with physical health status, women with trauma histories with poorer health status; employment (â = .202; p = .010) was positively associated with physical health status, employed women reported better health status. In the second analysis, perceived stress (â = -.378; p = .000) was negatively associated with mental health status. The third analysis revealed that birthplace (p = .031; â = .161), perceived stress (â = .345; p = .000) and trauma history (â = -.233; p = .002) were negatively associated with overall health status, with foreign-born women reporting poorer health status. The final analysis revealed that years of education (â = .140; p = .029) and perceived stress (â = .556; p = .0000) were positively associated with depressive symptoms, with women with more years of education and less perceived stress reporting fewer depressive symptoms. Conclusion: These results provide evidence that stress and a trauma history combined with socio-demographic factors are predictive of depressive symptoms and mental and physical health status and should be screened during primary care visits during and post-pregnancy.