Perinatal trauma, early parenting, and family processes

• In Event: 2-174 - Family Trauma and Parenting Processes

Integrative Statement

Background: Trauma-affected women may be prone to depression (Robertson-Blackmore et al., 2013) and unhealthy behaviors during pregnancy (Chung et al., 2010), including smoking (Lopez et al., 2012). Unhealthy behaviors during pregnancy are associated with heightened risk of unfavorable birth outcomes (Cox et al., 2011). Notably, adverse birth outcomes are more likely for African American women (CDC, 2016).There is sparse literature on family processes that may protect women against the negative impact of perinatal trauma, and how perinatal trauma may affect mothers’ parenting.
The current study was designed to examine whether experience of trauma was related to health practices during pregnancy, and whether these factors predicted adverse birth outcomes. We explored the protective role of father involvement for trauma-affected women on their health practices, and assessed mothers’ interactions with their infants to explore the influence of perinatal trauma on parenting.
Method: Participants were 95 pregnant women recruited from WIC and Early Head Start in a metropolitan area. To be included, women had to be African American, over 28 weeks gestation, between 18-35 years-old, and English-speaking. Women were excluded if they had a history of fetal or infant death, known medical conditions, or abnormal diagnostic results. Mean maternal age was 25.27(SD=4.31); 94.6% had at least a high school diploma; and 60.7% reported being single.
Mothers were interviewed in their homes during the third trimester, and over the phone 2 weeks after delivery. Measures included: Health Practices in Pregnancy Questionnaire (Lindgren, 2005; M=70.97; SD=8.55); Trauma History Questionnaire (Green, 1996; M=3.09; SD=2.81); Edinburgh Postnatal Depression Scale (Cox et al., 1987; M=5.61; SD=4.61); and Father Involvement Questionnaire (Cabrera et al., unpublished; M=5.55; SD=2.74). Parenting was assessed via the Still Face Paradigm (Tronick et al., 1980) when the infants were between 4-6 months old.
Results: We regressed health practices on trauma, depression, father involvement, and maternal age (see Table 1); about 11% of the variance in health practices was explained by these predictors. Mothers’ trauma scores and depression scores were significant predictors of health practices. Father involvement moderated the relation between trauma and health practices, such that for mothers with high father involvement, lower levels of trauma and depression were associated with better health behaviors.
We also conducted a logistic regression examining expected predictors of adverse birth outcomes. Smoking during pregnancy and past experiences of abuse significantly predicted adverse birth outcomes (χ2 = 6.69, df = 2, p <.05). As seen in Table 2, the odds of an adverse birth outcome are increasingly greater as the number of experiences of abuse increases. Finally, data on early parenting have been collected, are currently being coded, and will be analyzed for the presentation in March, if this symposium is accepted.
Conclusion: We found that trauma was related to perinatal health practices, and that high father involvement is protective for women with lower levels of trauma. Additionally, the most severe type of trauma (i.e., abuse) was linked to adverse birth outcomes. These findings will be considered regarding research and intervention for pregnant women who have experienced trauma.

Authors

• Brenda Jones-Harden, University of Maryland
  Presenting Author

• Colleen Morrison, James Bell Associates
  Non-Presenting Author

• Shelby Brown, Towson University
  Non-Presenting Author