Characteristics Associated with Severe Psychological Distress (SPD) in a Cohort of African American (AA) Pregnant Women

Background: Severe PD has been linked to preterm birth (PTB), and low birth weight (LBW). Few studies have examined characteristics that may be associated with SPD in AA pregnant women.

Objective: The objective of this study was to determine which demographic, health behavior, and psychosocial characteristics were associated with SPD in a cohort of pregnant AA women.

Methods: Data were obtained from a retrospective cohort of 1410 AA women in metropolitan Detroit, Michigan using maternal interviews and medical record abstraction (71% response rate). Kessler’s six-item questionnaire of psychological distress (K6; 0-“never” to 4-“very often”, range: 0-24) was used to evaluate SPD. Descriptive statistics and multivariable logistic regression were used to examine the associations between SPD (score≥13) and the following characteristics: maternal age, education, marital status, employment, smoking, physical health rating, father-of-the-baby (FOB) support, and Cohen’s perceived stress.

Results: 9% of women had SPD; women with SPD compared to women without had higher rates of PTB (22.9% vs. 16.8%; X2=2.5, p=0.12) and LBW (19.0% vs. 12.0%; X2=4.3, p=0.04). Regression models showed marital status (p=0.03), education (p=0.03), employment (p=0.04), perceived stress (p<0.01), and FOB support (p<0.01) were significantly associated with SPD. Physical health was moderately significant (p=0.05). Women who were stay-at-home were 2.0 times (95%CI:1.1-3.6) as likely as those employed to have SPD. Women who reported negative FOB support versus positive FOB support were twice as likely (OR=2.0, 95%CI:1.3-3.0) to have SPD.  

Significance/Implication: Understanding the characteristics related to SPD in AA pregnant women is important for mental health screening and intervention development.