Variation and correlates of psychosocial wellbeing among nulliparous women with preeclampsia

Theresa M Boyer; Arthur J Vaught; Alison Gemmill

doi:10.1016/j.preghy.2024.101121

Variation and correlates of psychosocial wellbeing among nulliparous women with preeclampsia

Pregnancy Hypertens. 2024 Mar 28:36:101121. doi: 10.1016/j.preghy.2024.101121. Online ahead of print.

Authors

Theresa M Boyer¹, Arthur J Vaught², Alison Gemmill³

Affiliations

¹ Department of Epidemiology, Baltimore, MD, USA. Electronic address: tboyer3@jhmi.edu.
² Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
³ Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

PMID: 38552368
DOI: 10.1016/j.preghy.2024.101121

Abstract

Objectives: To identify classes of psychosocial stressors among women who developed preeclampsia and to evaluate the associations between these classes and correlates of psychosocial wellbeing.

Study design: We performed a secondary analysis of women who developed preeclampsia (n = 727) from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) cohort (2010-2013). Latent class analysis was used to identify classes of social stressors based on seven psychological and sociocultural indicators. Associations between latent classes and correlates (demographics, health behavior, and health-systems level) were estimated using multinomial logistic regression.

Main outcome measures: Classes of psychosocial wellbeing.

Results: Among women who developed preeclampsia, three classes reflective of psychosocial wellbeing were identified: Class 1: Intermediate Psychosocial Wellbeing (53 %), Class 2: Positive Psychosocial Wellbeing (31 %), Class 3: Negative Psychosocial Wellbeing (16 %). Women in the Negative Psychosocial Wellbeing Class were more likely to have poor sleep and a sedentary lifestyle compared with the Positive and Intermediate Psychosocial Wellbeing Classes. Both the Negative and Intermediate Psychosocial Wellbeing Classes reported concern about their quality of medical care compared with the Positive Psychosocial Wellbeing Class (adjusted odds ratio [aOR]: 6.19, 95 % confidence interval [CI]: 3.37, 11.36 and aOR: 2.19, 95 % CI: 1.31, 3.65, respectively).

Conclusions: Women who develop preeclampsia are heterogenous and experience different intensities of internal and external stressors. Understanding the linkages between psychosocial wellbeing during pregnancy and modifiable behavioral and structural factors may inform future tailored management strategies for preeclampsia and the optimization of maternal postpartum health.

Keywords: Allostatic load; Maternal health; Preeclampsia; Pregnancy; Psychosocial; Stress.

Grants and funding

T32 HL007024/HL/NHLBI NIH HHS/United States