Stressful Life Event Experiences of Pregnant Women in the United States: A Latent Class Analysis

Abstract

ObjectivesNearly 65% to 70% of pregnant women in the United States experience one or more stressful life events (SLEs), which can lead to adverse maternal and/or fetal outcomes. This study aimed to identify groups of women with similar patterns of antenatal SLE experiences, and to examine their sociodemographic correlates. MethodsData from the 2009 to 2011 Pregnancy Risk Assessment Monitoring System were used and latent class analysis performed (N = 115,704) to identify unobserved class membership. The relative likelihood of membership in each latent class was explored using multinomial logistic regression. ResultsA three-class model was the most appropriate, with the majority (64%) in the low-stress class. The illness/death related-stress class (13%) had a high prevalence of illness (77%) and death (63%) of someone close or a family member, whereas those in the multiple stressors (22%) class endorsed most other SLEs. Unmarried and lowest poverty women were, respectively, more (adjusted odds ratio, 2.36; 95% confidence interval, 2.12–2.62) and less likely (adjusted odds ratio, 0.09; 95% confidence interval, 0.07–0.11) to be in the multiple stressors class. The highest prevalence of severe pregnancy-associated nausea/vomiting, preterm labor, and postpartum depression was in the multiple stress class, followed by illness/death, and low-stress classes. ConclusionsThat one out of every five and one out of every eight women were in the multiple stressors and illness/death related-stress classes, respectively, suggests that antenatal SLEs are common. The greater likelihood of adverse maternal health outcomes in both the illness/death stress and the multiple stressors classes suggests the importance of screening for these SLEs and providing support to pregnant women.