Healthy Beginnings: Exploring the Impact of Parental Stress and Relationship Quality on Birth Outcomes

This dissertation consists of three studies exploring the effects of maternal and paternal experiences of stress and perceptions of relationship quality on length of gestation and birth weight. The first study assessed the association of parental relationship quality with the baby’s length of gestation and birth weight among 2,072 families in the Fragile Families and Child Wellbeing study. Romantic relationships can be a substantial source of social support as well as stress, and have been shown to influence many health outcomes. Beyond crude relationship characteristics, however, few studies have assessed the association of other dimensions of relationship quality, such as conflict and support, with birth outcomes. No studies have assessed the association of father’s report of relationship quality with birth outcomes. In this study, multilevel linear regression analyses found that babies born to fathers who were present at their birth were born significantly heavier and had a longer gestation. The results also showed that greater paternal relationship conflict was associated with lower gestational age among all couples and lower birth weight among unmarried couples. The second study investigated the association between parental stress during pregnancy with their baby’s length of gestation and birth weight among a sample of 270 young couples in southern Connecticut. Many studies have shown that women’s experiences of stress during pregnancy are associated with preterm birth and low birth weight; however, men’s experiences have largely been ignored. Structural equation modeling of the association between maternal and paternal stress latent variables and birth outcomes showed that greater paternal stress was significantly associated with longer gestation and greater birth weight, while maternal stress was not significantly associated with these outcomes. The findings from the first two studies suggest that men’s experiences and feelings when they are expecting a baby may have a unique contribution to birth outcomes. The third study assessed the association between parental stress during pregnancy and their own and their partner’s poor health behaviors and depressive symptoms among a sample of young couples in lower Connecticut. Many unhealthy behaviors, such as substance use, develop during adolescence and evidence shows that stress is a contributing factor. This association has not been established among pregnant adolescents and little attention has been paid to male partners. Among a sample of 294 young expectant couples, multilevel modeling showed that one’s own experiences of stress were associated with more unhealthy behaviors and depressive symptoms for both members of the couple. Cross-over effects were also evident—paternal stress was predictive of more maternal conduct problems, while maternal stress was predictive of less paternal substance use and more depressive symptoms. These findings highlight the importance of social relationships and interactions on health behaviors. Overall, the results of the three studies suggest that father’s experiences during pregnancy matter to their baby’s health, and that experiences of stress during pregnancy may impact an expectant couples’ own and their partner’s health behaviors. This dissertation research treated men’s experiences during pregnancy, including experiences of stress and relationship quality, with equal weight to women’s experiences when it came to their impact on birth outcomes and health behaviors. Future, research, programs and policies aimed at improving birth outcomes may be strengthened by the inclusion of expectant fathers

Romantic partner influences on prenatal and postnatal substance use in young couples.

Background: Alcohol, tobacco and other drug use (ATOD) among adolescent and young adult couples during prenatal and postnatal periods is a significant public health problem, and couples may mutually influence each others' ATOD behaviors. Purpose: The current study investigated romantic partner influences on ATOD among adolescent and young adult couples during pregnancy and postnatal periods. Methods: Participants were 296 young couples in the second or third trimester of pregnancy recruited from OBGYN clinics between July 2007 and February 2011. Participants completed questionnaires at prenatal, 6 months postnatal, and 12 months postnatal periods. Dyadic data analysis was conducted to assess the stability and interdependence of male and female ATOD over time. Results: Male partner cigarette and marijuana use in the prenatal period significantly predicted female cigarette and marijuana use at 6 months postnatal (b = 0.14, P < 0.01; b = 0.11, P < 0.05, respectively). Male partner marijuana use at 6 months postnatal also significantly predicted female marijuana use at 12 months postnatal (b = 0.11, P < 0.05). Additionally, significant positive correlations were found for partner alcohol and marijuana at pre-pregnancy and 6 months postnatal, and partner cigarette use at pre-pregnancy, 6 months and 12 months postnatal. Conclusions: Partner ATOD among young fathers, particularly during the prenatal period, may play an important role in subsequent ATOD among young mothers during postnatal periods.VoRSUNY DownstateCommunity Health SciencesN/

Stress and behavioral risk among young expectant couples

Few studies have explored stress and coping among adolescents who are expecting a baby. In particular, young men's experiences during pregnancy have largely been ignored, despite the fact that a young man's experiences and behaviors carry implications for his own, his partner's and his child's health. This study examined the association between maternal and paternal experiences of stress during pregnancy with one's own and one's partner's health behaviors and depressive symptoms among 294 young expectant couples in the U.S. Multilevel modeling showed that one's own experiences of stress were associated with more unhealthy behaviors and more depressive symptoms among both expectant mothers and fathers. Paternal experiences of stress were predictive of more maternal conduct problems, while maternal experiences of stress were predictive of more paternal depressive symptoms and less paternal substance use. These findings highlight the importance of social relationships in affecting health behaviors and mental health among expectant adolescents