Prenatal Distress and Parenting Stress: The Moderating Role of Social Support

• In Event: Stress Across the Transition to Parenthood

Abstract

Maternal mental health has profound implications for child social, emotional, and cognitive development and is one of the earliest modifiable factors in a child’s life (Kingston & Tough 2014). Maternal mental health issues are common during pregnancy; between 20-25% of mothers experience anxiety during pregnancy (Field, 2017), and prenatal maternal mental health issues such as anxiety are strong predictors of postnatal mental health issues (Henderson & Redshaw, 2013) and lower emotional involvement with infants during the early postpartum period (Figueiredo & Costa, 2009), which is why the identification of protective factors for maternal mental health is critical. Prenatal anxiety has been associated with parenting stress in the first year postpartum among higher educated women (Huizink et al., 2017), but the association among historically disadvantaged women is understudied. Social support has been identified as an important protective factor for postpartum maternal mental health (Meadows, 2010). This study uses longitudinal data to examine the longitudinal association between pregnancy anxiety during the 3rd trimester and parenting stress at two months postpartum. Additionally, we examine the potential moderating impact of perceived social support on the association.
Data for the current study came from a longitudinal, urban, clinic-based cohort study involving 177 pregnant women (ages 16-38) recruited in 2017-2018. The participating clinics serve a racially diverse and underserved patient population. The sample for the current study was restricted to the 124 participants who responded to five survey waves, occurring from the first trimester of pregnancy through two months postpartum. Demographic variables were measured at the first assessment, which occurred at the first prenatal appointment in the first trimester. Social support was assessed in the 2nd trimester using the Perceived Social Support Scale (Zimet et al., 1988). Prenatal anxiety was measured during the 3rd trimester using the Prenatal Distress Questionnaire (Yali & Lobel, 1999). Parenting stress was measured using the Parenting Stress Index (Abidin, 1983) at two months postpartum.
Multiple linear regression models were used to examine associations between prenatal anxiety and parenting stress and the interaction with social support. Results indicate that higher levels of prenatal anxiety in the third trimester were significantly related to higher levels of parenting stress, and the presence of social support was associated with lower levels of parenting stress, at two months postpartum, controlling for sociodemographic characteristics. A second model with the interaction between prenatal anxiety and social support added revealed a significant interaction (b=.006; p<.001). The interaction was plotted to ease understanding for readers.
Similar to prior research, we found that prenatal anxiety predicted parenting stress at two months postpartum. We also found that social support was protective for parenting stress predominately among those with lower prenatal anxiety; women with high levels of prenatal anxiety have higher levels of parenting stress regardless of social support. These results highlight the need for targeted intervention measures for those who report high levels of prenatal anxiety in order to reduce later parenting stress.

Authors

• Kayleigh Anne Evans, Oklahoma State University - Stillwater
  Presenting Author

• Karina M. Shreffler, University of Oklahoma Health Sciences Center

• Karla Finnell, University of Oklahoma Health Sciences Center