Majority of Women Experience Stressful Life Events In Year Before Giving Birth Interview with:
Elizabeth Burns, MPH

Rollins School of Public Health
Emory University

MedicalResearch: What is the background for this study? What are the main findings?

Response: Epidemiologic studies suggest that prenatal stress is associated with preterm birth, low birth weight and peripartum anxiety and depressive symptoms. The most recent population-based study on the prevalence of stress among pregnant women, which used data from 1990-1995, reported that 64% of women experience stressful life events (SLEs) in the year before their infant’s birth. More recent estimates of prevalence and trends of prenatal stressful life events are useful for clinicians in order to understand the risk profile of their patients.

The Pregnancy Risk Assessment Monitoring System (PRAMS) collects self-reported information on maternal experiences and behaviors before, during, and after pregnancy among women who delivered a live infant. PRAMS includes 13 questions about maternal SLEs experienced in the year preceding the birth of the child. Based on previous research, SLEs were grouped into four dichotomous constructs:

1) emotional stressors (family member was ill and hospitalized or someone very close died);
2) financial stressors (moved to a new address, lost job, partner lost job, or unable to pay bills);
3) partner-associated stressors (separated/divorced, argued more than usual with partner/husband, or husband/partner said he did not want pregnancy); and
4) traumatic stressors (homeless, involved in a physical fight, partner or self-went to jail, or someone very close had a problem with drinking or drugs).

The prevalence of self-reported stressful life events decreased modestly but significantly during 2000–2010. Despite this, 70.2% of women reported ≥1 SLEs in 2010. Prevalence of stressful life events vary by state and maternal demographic characteristics and are especially prevalent among younger women, women with ≤12 years of education (75.6%), unmarried women (79.6%), and women that were covered by Medicaid for prenatal care or delivery of their child (78.7%).

MedicalResearch: What should clinicians and patients take away from your report?

Response: Current American College of Obstetricians and Gynecologists antepartum care guidelines recommend that women be screened for psychosocial complications and social support. Clinicians should be aware that although stressful life events are especially prevalent among low-income, younger, unmarried, and less educated women, the majority of women with a college education (59.6%), with private insurance (64.2%), and who are married (64.2%) also experience stressful life events.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Response: It would be beneficial to understand how physicians screen their pregnant patients for psychosocial stress and social support, when and where they refer their patients with high levels of stress or stressful life events, and how effective interventions and referrals are for reducing stress. Additionally, more research is needed to develop and scale up effective programs that reduce stress among pregnant women.


Stressful Life Events Experienced by Women in the Year Before Their Infants’ Births — United States, 2000–2010


March 13, 2015 / 64(09);247-251 Interview with: Elizabeth Burns, MPH (2015). Majority of Women Experience Stressful Life Events In Year Before Giving Birth 

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