129 - Associations between Maternal Stress and Resilience at the Onset of Pregnancy

Poster Number: 129
Publication Number: 129.1303

Background: Maternal stress is linked to infant low birthweight and decreased human milk provision. Resilience, a person’s self-reported ability to deal with stress, has been associated with improved health outcomes among adults and may be modifiable. Data linking different types of maternal stress and resilience during pregnancy is limited.

Objective: To explore associations between three measures of maternal stress and self-reported maternal resilience in early pregnancy.

Design/Methods: This is a sub-analysis of an ongoing prospective longitudinal cohort study of English and Spanish-speaking pregnant people receiving prenatal care in a large, diverse, urban US city. Participants were recruited in their first trimester; Spanish-Speaking people were oversampled per main study’s primary aims. Participants completed validated scales for: remote childhood stress (Adverse Childhood Experiences, ACEs), chronic stress over the past year including pregnancy-specific stressors (Prenatal Social Environment Inventory, PSEI), and acute stress in the past month (Perceived Stress Scale, PSS). They also completed the Connor-Davidson Resilience Scale (CD-RISC) and provided demographic information. Per existing literature, acute, chronic, and remote childhood stress were categorized into three levels (low, medium, and high). Univariate analyses described the distribution of types of maternal stress at the onset of pregnancy. Linear regression models then tested the association between the three different types of stress and resilience. Analyses were adjusted for maternal sociodemographic variables and any history of chronic illness.

Results: Among 198 people who were, on average, 10 weeks pregnant when surveyed, 32% were Hispanic/Latine, 58% were employed full-time, and educational levels were high (Table 1). Participants reported a near even split of low, medium, and high number of ACEs, but 60% endorsed moderate or high acute stress in their first trimester (Fig. 1). Both moderate and high acute stress had a strong negative association with CD-RISC scores in unadjusted and fully adjusted models (β = -9.9, 95% CI -13.7, -6.1 and β = -16.2, 95% CI -25.7, -6.8, respectively) (Table 2).

Conclusion(s): The prevalence of acute stress was high among this cohort of pregnant people in their first trimester and was significantly associated with decreased self-reported resilience. Screening pregnant people’s acute stress at the onset of pregnancy may help identify those most likely to begin pregnancy with decreased resilience. Such individuals could be prioritized for stress mitigation interventions as a strategy to optimize infant health.