Variations in Relationships Between Perceived Stress and Birth Outcomes by Immigration Status

Matern Child Health J. 2020 Dec;24(12):1521-1531. doi: 10.1007/s10995-020-03014-1. Epub 2020 Oct 13.

Abstract

Introduction: Past research shows that stress during pregnancy predicts adverse birth outcomes. These patterns might differ based on immigration status. Our objective was to analyze differences in relationships between perceived stress during pregnancy and birth outcomes by immigration status.

Methods: We recruited 81 pregnant women in Canada for a prospective longitudinal study of stress during pregnancy and infant development. Participants completed the Perceived Stress Questionnaire at 16-18, 24-26 and 32-34 weeks of pregnancy. Birth records were available for 73 women, including 24 non-immigrants, 18 long-term immigrants (≥ 5 years), and 31 recent immigrants (< 5 years). We used General Linear Models to test relationships between perceived stress and birthweight, birthweight for gestational age Z-scores, and gestational age, and differences based on immigration status.

Results: Controlling for sociodemographic covariates, we observed interactive relationships between immigration status and perceived stress with birthweight at 16-18 (p = 0.032, partial η2 = 0.11) and 24-26 weeks pregnancy (p = 0.012, partial η2 = 0.15). Results were similar for birthweight for gestational age Z-scores at 16-18 weeks (p = 0.016, partial η2 = 0.13) and 24-26 weeks pregnancy (p = 0.013, partial η2 = 0.14). Perceived stress predicted smaller birthweight measurements among long-term immigrants. No relation was found between perceived stress, immigration status and gestational age.

Discussion: Risk of adverse health outcomes, including birth outcomes, tends to increase with duration of residence among immigrants. Stress during pregnancy might represent one risk factor for adverse birth outcomes among long-term immigrant women. Promoting psychosocial health screening and care among immigrant women, and assuring continued care with acculturation, might improve both maternal and infant health outcomes.

Keywords: Birthweight; Health disparities; Immigrant; Mental health; Migrant; Stress.

MeSH terms

  • Adult
  • Birth Weight
  • Cohort Studies
  • Emigrants and Immigrants / psychology*
  • Emigration and Immigration
  • Female
  • Gestational Age
  • Health Status Disparities
  • Healthcare Disparities
  • Humans
  • Infant, Newborn
  • Mental Health / ethnology*
  • Mental Health / statistics & numerical data
  • Pregnancy
  • Premature Birth / epidemiology*
  • Prospective Studies
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology
  • Surveys and Questionnaires