Psychological factors moderate the link between SES and inflammatory markers in pregnant women

Abstract

Elevated pro-inflammatory cytokines and decreased anti-inflammatory cytokines are linked with adverse perinatal health outcomes. One key contributor to inflammation is socioeconomic status (SES). Data examining psychological factors that modify the relationship between SES and inflammation in pregnancy are lacking. This study examined the roles of repetitive negative thinking (RNT) and presence of meaning in life on the SES-inflammation link among 67 pregnant women. A cumulative SES index defined as income, education, perceived social class, and receipt of governmental support was calculated. Measures included the Perseverative Thinking Questionnaire, Meaning in Life Questionnaire, IL-6, and IL-4. Relationships between SES with IL-6 (p = 0.08) and IL-4 (p = 0.47) were not significant. Using PROCESS, moderation analyses showed significant interactions between SES and psychological factors on inflammation. Greater SES was associated with (a) lower IL-6 levels among women reporting low RNT (p = 0.03) and (b) higher IL-4 levels among women reporting high presence of meaning in life (p = 0.02). These effects only emerged in women with high SES. Findings remained after adjustment for race, pre-pregnancy body mass index, exercise, gestational age at visit, and medical conditions. In sum, in pregnant women, greater SES was beneficial for inflammatory markers among women exhibiting enhanced psychological functioning. Future examinations should identify targets of psychological intervention that mitigate the effects of financial stress on inflammation in women with low SES.