Protective role of social support and mastery on the negative effects of perceived stress and intimate partner violence on the mental health of pregnant Latinas: A cross sectional and longitudinal investigation

Background: Maternal stress and exposure to intimate partner (IPV) violence has been linked to both negative maternal and infant physical and mental health outcomes. However psychosocial resources including social support and a sense of mastery may ameliorate the deleterious effects of maternal stress and IPV on maternal health. The study examined the direct and indirect effects of perceived stress, IPV and social support and mastery on the mental health of pregnant Latinas prenatally, after the first trimester and about one year post-partum. Methods: 210 Latinas (mean age = 27.7 years) mostly immigrant and low income Latinas recruited from prenatal clinics in Los Angeles participated in this study at the prenatal stage when they were at least twelve weeks pregnant and at the post-partum stage when their children were around one-year old. Structured interviews and self-report measures in English or Spanish were completed by participants. Hierarchical regression analyses with prenatal and post-partum depressive and post-traumatic stress disorder (PTSD) symptoms as the outcomes were conducted. Results: Women with IPV exposure and higher levels of perceived stress reported more depressive and PTSD symptoms at both time points. Social support was associated with less depressive symptoms cross-sectionally (b=-.24, p≤001) and longitudinally (b=-.32, p≤.001). However mastery was only associated with less depressive symptoms in the prenatal period (b=-.18, p<.05). Significant moderating effects of social support and mastery on perceived stress' association with symptoms were found. Social support buffered the effects of perceived stress on depressive symptoms at both time points (b=-.72, p<.05; b=-70, p<.05). Additionally, mastery buffered the relationship between perceived stress and prenatal depressive symptoms (b=-.72, p<.05). A trend for social supports protective effect on the association between perceived stress and prenatal PTSD symptoms was also found (b=-.57, p=.07). Conclusion: Perceived stress and exposure to IPV are risk factors for poor maternal mental health for Latinas. However, the psychosocial resources of mastery and social support may serve a protective function for these women. Findings highlight the need for health care providers to identify risk factors in pregnant women and encourage the development of psychological skills and social support networks in women with these risk factors in order to improve maternal and infant health.