BackHome
Refresh: OffView Personal Schedule
Individual Submission Summary
Share...

Direct link:

Promising Prenatal Intervention Effect on Physiological Stress for Low-income Parents

Fri, April 9, 2:45 to 4:15pm EDT (2:45 to 4:15pm EDT), Virtual

Abstract

During pregnancy, mothers typically experience a natural increase in cortisol that is necessary for healthy fetal development (Charis et al., 2001). However, excessive increases are related to poorer outcomes in terms of maternal health (Pluess et al., 2010), birth outcomes (Davis & Sandman, 2010), and greater infant sensitivity to stress (Tollenaar et al., 2011). Furthermore, research suggests that early in pregnancy, as early as the first trimester, is a particularly sensitive developmental window for the fetus (Davis et al., 2011). Yet most interventions for parents occur late in pregnancy or after birth, overlooking this sensitive period in development. The current study evaluated the efficacy of a couple-level, group-based, educational program, Preparing for Parenthood (PREP), in reducing physiological stress for parents in early pregnancy.

The PREP intervention aimed to: a) reduce stress and depression in expectant parents, b) strengthen the couple relationship, and c) enhance parenting knowledge. It was developed specifically to address the life stressors of low-income, racially and ethnically diverse families. The intervention is unique in that it included both mothers and fathers, as couple-based interventions have been shown to be most effective (Feinberg et al., 2010). PREP was developed in collaboration with a community-based family organization, and delivered by family support paraprofessionals, making it less resource-intensive and more sustainable than other family programs.

Twenty-four couples (48 participants) were assigned to the 6-week PREP intervention and 22 couples (46 participants) received treatment-as-usual (optional home visiting). Physiological stress was measured using salivary cortisol and collected at baseline (12-18 weeks gestation) and post-intervention (18-24 weeks gestation).

As shown in Figure 1, there were no mean difference between the intervention and control groups in mothers’ cortisol levels prior to the intervention (γ01 = -0.04, 95% CI = [-0.15, 0.07], p = .23). Post-intervention mothers in the intervention group had lower levels of cortisol compared to controls (γ01 = -0.23, 95% CI = [-0.36, -0.08], p < .01).
Results also indicated that mothers in the intervention group experienced a significantly smaller increase in cortisol from pre- to post-intervention (γ11 = -0.20, 95% CI = [-0.35, -0.06], p = .01). As depicted in Figure 1, mothers in the control group experience an increase in salivary cortisol that was approximately 3 times larger (simple slope = 0.29, 95% CI = [-0.72,1.63], p = .28) than mothers in the intervention group (simple slope = 0.10, 95% CI = [-0.92,1.49], p = .86), controlling for naps, exercise, wake time, and hours of sleep. However, there was no difference in the change in cortisol for fathers from pre- to post-intervention (γ11 = -0.12, 95% CI = [-0.45, 0.10], p = .28).

Results indicate that a partner-inclusive prenatal intervention for low-income parents reduces the increase in maternal, but not paternal, physiological stress during pregnancy. This is the first study to show post-intervention reductions during pregnancy which suggests this prenatal intervention has promise to mitigate prenatal physiological stress for at-risk families. This has significant implications for the perinatal prevention literature given the negative implications of heightened stress in early pregnancy.

Authors