Online Program

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

Tuesday, November 3, 2015

Lesya Ekshyyan, MPH(c), BS, Dornsife School of Public Health, Drexel University, Philadelphia, PA
Jaime Slaughter, PhD, MPH, Department of Doctoral Nursing, College of Nursing & Health Professions, Drexel University, Philadelphia, PA
Dawn Misra, PhD, Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit
Cleopatra Caldwell, PhD, Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
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.

Learning Areas:

Diversity and culture
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify differences in maternal characteristics that may be associated with severe psychological distress in AA pregnant women Discuss why understanding which maternal characteristics are associated with severe psychological distress in vulnerable pregnant populations is important to research that focuses on mental health screening and the development of interventions aimed reducing adverse pregnancy outcomes

Keyword(s): Birth Outcomes, Vulnerable Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Master of Public Health student and researcher focusing on public health issues and topics in epidemiology, women's health, mental health, and health disparities. I have performed substantial research in the field of maternal and child health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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