Lack of partner impacts newborn health through maternal depression: A pilot study of low-income immigrant Latina women

Highlights

• Maternal mental health conveys the quality of the psychosocial environment.

• Theory suggests the child will develop based on the information conveyed.

• Impact of relationship status and planned pregnancy on depression were examined.

• Being single indirectly affected child health through prenatal depression.

• Pregnancy-related stressors may be important to probe by physicians.

Abstract

Introduction

Latina women have a high burden of depression and other mental health issues, particularly in the perinatal period. Suboptimal maternal mental health can have adverse developmental and physiological impacts on child growth. The present study examines the impact of unplanned pregnancy and pregnancy relationship status on prenatal maternal depression in a sample of low-income Latina women. We hypothesized that the association between these prenatal stressors and newborn health would be mediated through prenatal depression.

Method

The present study included a sample 201 Latina mothers and their children recruited from prenatal clinics during their second or third trimesters. Depression symptomology, relationship status were collected prenatally. At birth, several indices of newborn health were examined, including head circumference percentile and birthweight. Finally, planned pregnancy status was retrospectively collected when the child was between 1 and 2 years old.

Results

Structural equation modelling revealed that single women, compared to partnered women, had higher levels of depression. Higher levels of depression, in turn, predicted poorer newborn health. Unplanned pregnancy was not significantly associated with newborn health.

Discussion

These results suggest that relationship status may be an important screening question for medical examiners to ask to pregnant Latina women during prenatal visits. These results are consistent with past research investigating the effects of maternal mental health on adverse birth outcomes that propose that stressful early environments shape developmental trajectories.

Introduction

Pregnancy can engender intense physical and emotional upheavals in women. Psychosocial and cultural factors may not only exacerbate or diminish pregnancy-related stressors (Dunkel Schetter, 2011), but may buffer their effects on pregnancy outcomes. Evolutionary perspectives (Ellis, 2004, Hrdy, 2000) suggest that instrumental and social support from one's partner and family are of importance and can impact child health and development (Ellis, 2004, Flinn, 2006). The intense physiological and temporal burden of pregnancy orients women to be selective of when and with whom they have a child (Ellison, 2003, Trivers, 1972). Medical anthropological frameworks similarly emphasize the role men play as mates and fathers in matters of maternal and infant health (Dudgeon and Inhorn, 2004). Succinctly put, the men as partners framework posits that men, directly and indirectly, help shape the health of women and infants during pregnancy (Dudgeon and Inhorn, 2004).

The impact of partner presence (i.e., maternal relationship status) and maternal relationship health on physical development, interpreted through an evolutionary perspective, has been mainly focused on physical health and development in adolescence (Ellis et al., 1999, Ellis and Garber, 2000). For instance, both maternal mental health and partner absence was implicated in early pubertal development in girls. As such, we argue that the effects of father presence (i.e., maternal relationship status), may have a similar effect on physical health in newborns, through maternal mental health.

Maternal mental health and the presence of prenatal stressors are critical in shaping newborn health (Diego et al., 2006, Dole, 2003, Grote et al., 2010). Depression may play an especially important role for Latina women given findings that the prevalence of depression among pregnant Latinas is at 32.4% (Lara et al., 2009). Additionally, current theoretical conceptualizations propose that maternal mental health during pregnancy may communicate or convey contextual information to the developing child regarding the quality of the psychosocial environment (Del Giudice, 2012, Dunkel Schetter and Tanner, 2012). The quality or supportiveness of the psychosocial context (conveyed through maternal mental health) should impact infant well-being.

For this reason, we investigate in a sample of Latina women two prenatal stressors that capture the condition of the mother's environment and indicate whether her social support and material resources are sufficient. The current study investigates the effects of two common stressors on prenatal depression – maternal relationship status and planned pregnancy status – and the impact of depression on newborn health in a sample of low-income Latina women. Both single motherhood and an unwanted or unplanned pregnancy have been linked to neonatal mortality and poorer maternal and child health (Angel and Worobey, 1988, Berkman et al., 2015, Gaudino et al., 1999). Infants without a reported father on their birth certificate were at increased risk for infant mortality, when controlling for other risk factors (Gaudino et al., 1999). We hypothesized that

• Single women and women reporting an unplanned pregnancy will report greater depression than women in relationships or women reporting planned pregnancies,

• Greater maternal depression will predict poorer newborn health,

• Maternal depression will mediate the relationship between maternal relationship status and unplanned pregnancies with newborn health.