Poster #165 - Development/validation of an instrument concerning stresses resulting from transition to parenthood: Birth Preparation Worry Scale

• In Event: 2-110 - Poster Session 07
  In Poster Session: PS 07 Section - Prevention and Interventions

Integrative Statement

Prenatal maternal stress increases adverse health outcomes for offspring across their lifespan, from premature birth to cardiovascular and metabolic risks in adulthood (e.g., Barker, 1995; Talge, Neal & Glover, 2007). The construct of pregnancy-specific anxiety emerged as an important predictor of infant/child outcomes, beyond general trait/state anxiety indicators (Huizink et al., 2004). Several measures assess worry about stressful events that occur during and as a result of pregnancy including adverse child outcomes, changes in physical appearance, and the process of giving birth (e.g., the Pregnancy-Related Anxiety Questionnaire; PRAQ; van den Bergh, 1990). However, no measure to date has addressed the uncertainty that women face with respect to logistics of transitioning to parenthood. In this study, we sought to develop an instrument to examine stress/worry surrounding women’s perceived preparation for parenthood and supporting their infant following its birth. For example, the measure was designed to assess concerns pertaining to the capacity to provide sufficient care for the baby, having adequate resources/supports to raise a child, and the impact of the baby on life domains including limited time for chores and recreation/relaxation or pressure on a romantic relationship. To develop this measure, the “Baby Preparation Worry Scale” (BPWS), we considered common sociocultural challenges and stressors surrounding pregnancy and the transition to parenthood, conducted focus group interviews, and consulted with experts in the field to generate a final list of 16 items (Table 1).

Expectant mothers in their third trimester of pregnancy (i.e., 27-40 weeks gestation) were recruited through a combination of community flyers, advertisements on social media, birthing classes, and medical centers in Eastern Washington and Northern Idaho. Of the 176 agreeing to take part, 142 met the final inclusion criteria. Participants were excluded due to high risk pregnancy factors. The most common reasons for exclusion included prenatal hypertension and gestational diabetes. The PRAQ total and 3 subscales were used to assess pregnancy-specific anxiety, with the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987) addressing prenatal depression. To assess state- and trait-level anxiety, the State Trait Anxiety Inventory (STAI; Spielberger et al., 1989) was used.

Internal consistency of BPWS was good (alpha > .90), and all items uniquely contributed to the scale; therefore, no items were discarded. To assess construct validity, we investigated relations between the BPWS and relevant prenatal mental health symptom measures, using bivariate correlations. Specifically, BPWS was expected to correlate positively with measures of maternal (trait- and state-level) anxiety and depression. As hypothesized, significant positive correlations emerged between the BPWS scale and all measures of prenatal symptomatology (p<.01; Table 2). That is, it showed strong, positive relations with maternal depression via the EPDS, pregnancy-specific anxiety via the PRAQ and each of its subscales (fear of child outcomes, giving birth, and changes in physical appearance), and both prenatal state and trait anxiety via the STAI. BPWS is of particular relevance to worry surrounding parenthood in the United States, in contrast to cultures that practice multi-generational living and/or allow extended parental leave.

Authors

• Alyssa Neumann, Washington State University
  Presenting Author

• Nora Erickson, University of Michigan
  Non-Presenting Author

• Maria Gartstein, Washington State University
  Non-Presenting Author