Examining the relationship between maternal stressful life events and urogenital infection in preterm birth using a biobehavioral model
Anderson, Joy Lavonne
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This dissertation examined the relationship between maternal stressful life events and urogenital infection in preterm birth. A systematic literature review revealed ambivalent findings concerning the relationship between maternal stress and infection during pregnancy; the effects of this relationship on pregnancy outcome were not examined in the reviewed studies. The current study employed a biobehavioral model consisting of maternal stressful life events (illness among family members, divorced, moved, became homeless, partner lost job, mom lost job, argued with partner more than usual, partner did not want the child, inability to pay bills, got in a physical fight, partner went to jail, close friend/relative had a bad problem with drinking or drug use, and close friend/relative died) and urogenital infection (genital warts, herpes, chlamydia, gonorrhea, pelvic inflammatory disease, syphilis, Group B streptococcus, bacterial vaginosis, trichomoniasis, yeast infection, urinary tract infection, and other infection) to examine the relationship between these variables in preterm birth. Data from 1,647 respondents of the 2005 Florida Pregnancy Risk Assessment Monitoring System survey were analyzed using descriptive statistics, chi-square and student t- tests, analysis of variance, and structural equation modeling (SEM). Of the respondents, 42% were White, 37.8% had preterm deliveries, and the mean age was 27.1 years. White mothers who became homeless (p = 0.021) or had a partner in jail (p = 0.041) during the 12 months prior to delivery had more preterm deliveries as compared to full-term deliveries. Other non-White mothers who had an ill family member (p = 0.010) had fewer preterm deliveries. In general, mothers diagnosed with Group B streptococcus during pregnancy (p = 0.031) had fewer preterm deliveries. Black mothers diagnosed with herpes (p = 0.006) had fewer preterm deliveries. SEM revealed a significant relationship between maternal stress and infection, in general (p < 0.001), and among White (p < 0.001), Black (p < 0.001), and Hispanic (p < 0.001) mothers. The interaction between these variables was not significant, in general, or among racial/ethnic groups. Results of this study indicate that culturally tailored prevention programs designed to help women cope with multiple risk factors may prove beneficial in reducing preterm birth rates.