Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Who is distressed? A comparison of psychosocial stress in pregnancy across seven ethnicities

Authors: Alexandra M. Robinson, Karen M. Benzies, Sharon L. Cairns, Tak Fung, Suzanne C. Tough

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

Login to get access

Abstract

Background

Calgary, Alberta has the fourth highest immigrant population in Canada and ethnic minorities comprise 28 % of its total population. Previous studies have found correlations between minority status and poor pregnancy outcomes. One explanation for this phenomenon is that minority status increases the levels of stress experienced during pregnancy. The aim of the present study was to identify specific types of maternal psychosocial stress experienced by women of an ethnic minority (Asian, Arab, Other Asian, African, First Nations and Latin American).

Methods

A secondary analysis of variables that may contribute to maternal psychosocial stress was conducted using data from the All Our Babies prospective pregnancy cohort (N = 3,552) where questionnaires were completed at < 24 weeks of gestation and between 34 and 36 weeks of gestation. Questionnaires included standardized measures of perceived stress, anxiety, depression, physical and emotional health, and social support. Socio-demographic data included immigration status, language proficiency in English, ethnicity, age, and socio-economic status.

Results

Findings from this study indicate that women who identify with an ethnic minority were more likely to report symptoms of depression, anxiety, inadequate social support, and problems with emotional and physical health during pregnancy than women who identified with the White reference group.

Conclusions

This study has identified that women of an ethic minority experience greater psychosocial stress in pregnancy compared to the White reference group.
Literature
1.
Dyck R, Osgood N, Lin TH, Gao A, Stang MR. Epidemiology of diabetes mellitus among First Nations and non-First Nations adults. Can Med Assoc J. 2010;182(3):249–56.CrossRef
2.
Kim I-H, Carrasco C, Muntaner C, McKenzie K, Noh S. Ethnicity and postmigration health trajectory in new immigrants to Canada. Am J Public Health. 2013;103(4):e96–e104.PubMedPubMedCentralCrossRef
3.
Tarricone T, Stivanello E, Poggi F, Castorini V, Marseglia MV, Fantini MP, Berardi D. Ethnic variation in the prevalence of depression and anxiety in primary care: A systematic review and meta-analysis. Psychiatry Res. 2012;195(3):91–106.PubMedCrossRef
4.
Xu MA, McDonald JT: The mental health of immigrants and minorities in Canada: The social and economic effects. Canadian Issues. 2010;2010:29-31
5.
Lassetter JH, Callister LC. The impact of migration on the health of voluntary migrants in Western societies: A review of the literature. J Transcult Nurs. 2009;20(1):93–104.PubMedCrossRef
6.
Beijers R, Jansen J, Riksen-Walraven M, de Weerth C. Maternal prenatal anxiety and stress predict infant illnesses and health complaints. Pediatrics. 2010;126(2):e401–9.PubMedCrossRef
7.
Drake AJ, Liu L. Intergenerational transmission of programmed effects: Public health consequences. Trends Endocrinol Metab. 2010;21(4):206–13.PubMedCrossRef
8.
Patrick TE, Bryan Y. Research strategies for optimizing pregnancy outcomes in minority populations. Am J Obstet Gynecol. 2005;192(5, Supplement):S64–70.PubMedCrossRef
9.
Sword W, Watt S, Krueger P. Postpartum health, service needs, and access to care experiences of immigrant and Canadian-born women. J Obstetric Gynecologic Neonatal Nursing. 2006;35(6):717–27.CrossRef
10.
Lobel M, Cannella DL, Graham JE, DeVincent C, Schneider J, Meyer BA. Pregnancy-specific stress, prenatal health behaviors, and birth outcomes. Health Psychol. 2008;27(5):604–15.PubMedCrossRef
11.
Zelkowitz P, Saucier JF, Wang T, Katofsky L, Valenzuela M, Westreich R. Stability and change in depressive symptoms from pregnancy to two months postpartum in childbearing immigrant women. Archives Women’s Mental Health. 2008;11(1):1–11.CrossRef
12.
Ahmed A, Stewart DE, Teng L, Wahoush O, Gagnon AJ. Experiences of immigrant new mothers with symptoms of depression. Archives Women’s Mental Health. 2008;11(4):295–303.CrossRef
13.
Ding H, Hargraves L. Stress-associated poor health among adult immigrants with a language barrier in the United States. J Immigr Minor Health. 2009;11(6):446–52.PubMedCrossRef
14.
Hamdan A. Mental health needs of Arab women. Health Care Women Int. 2009;30(7):593–611.CrossRef
15.
Roy-Matton N, Moutquin J-M, Brown C, Carrier N, Bell L. The impact of perceived maternal stress and other psychosocial risk factors on pregnancy complications. Obstet Gynecol Surv. 2011;66(8):475–6.CrossRef
16.
Dominguez TP, Schetter CD, Mancuso R, Rini CM, Hobel C. Stress in African American pregnancies: Testing the roles of various stress concepts in prediction of birth outcomes. Ann Behav Med. 2005;29(1):12–21.PubMedCrossRef
17.
Barret ES, Goldstein A, Hobel CJ. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol. 2008;51(2):333–48.CrossRef
18.
Shapiro GD, Fraser WD, Frasch MG, Séguin JR. Psychosocial stress in pregnancy and preterm birth: Associations and mechanisms. J Perinatal Med. 2013;41(6):631–45.CrossRef
19.
Giscombé CL, Lobel M. Explaining disproportionately high rates of adverse birth outcomes among African Americans: The impact of stress, racism, and related factors in pregnancy. Psychol Bull. 2005;131(5):662–83.PubMedCrossRef
20.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150(6):782–6.PubMedCrossRef
21.
Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67(10):1012–24.PubMedPubMedCentralCrossRef
22.
Azar R, Singer S. Maternal prenatal state anxiety symptoms and birth weight: A pilot study. Central Eur J Med. 2012;7(6):747–52.
23.
24.
Fleuriet KJ, Sunil TS. Perceived social stress, pregnancy-related anxiety, depression and subjective social status among pregnant Mexican and Mexican American women in south Texas. J Health Care Poor Underserved. 2014;25(2):546–61.PubMedCrossRef
25.
Glynn LM, Schetter CD, Hobel CJ, Sandman CA. Pattern of perceived stress and anxiety in pregnancy predicts preterm birth. Health Psychol. 2008;27(1):43–51.PubMedCrossRef
26.
Rahman A, Bunn J, Lovel H, Creed F. Association between antenatal depression and low birthweight in a developing country. Acta Psychiatr Scand. 2007;115(6):481–6.PubMedPubMedCentralCrossRef
27.
Rondó PHC, Ferreira RF, Nogueira F, Ribeiro MCN, Lobert H, Artes R. Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr. 2003;57(2):266–72.PubMedCrossRef
28.
Wadhwa PD, Glynn L, Hobel CJ, Garite TJ, Porto M, Chicz-DeMet A, Wiglesworth AK, Sandman CA. Behavioral perinatology: Biobehavioral processes in human fetal development. Regul Pept. 2002;108(2–3):149–57.PubMedCrossRef
29.
O’Connor TG, Heron J, Glover V. Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Adolesc Psychiatry. 2002;41(12):1470–7.PubMedCrossRef
30.
Rice F, Harold GT, Boivin J, van den Bree M, Hay DF, Thapar A. The links between prenatal stress and offspring development and psychopathology: Disentangling environmental and inherited influences. Psychol Med. 2010;40(2):335–45.PubMedCrossRef
31.
Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E, Verdoux H. Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: A prospective survey of the MATQUID cohort. Eur Psychiatry. 2004;19(8):459–63.PubMedCrossRef
32.
33.
Moutquin J-M. Socio-economic and psychosocial factors in the management and prevention of preterm labour. Br J Obstet Gynaecol. 2003;110(20):56–60.CrossRef
34.
Campos B, Schetter CD, Abdou CM, Hobel CJ. Familialism, social support, and stress: Positive implications for pregnant Latinas. Cult Divers Ethn Minor Psychol. 2008;14(2):155–62.CrossRef
35.
36.
Rising SS, Kennedy HP, Klima CS. Redesigning prenatal care through CenteringPregnancy. J Midwife Women’s Health. 2004;49(5):398–404.CrossRef
37.
Miszkurka M, Goulet L, Zunzunegui MV. Contributions of immigration to depressive symptoms among pregnant women in Canada. Can J Public Health. 2010;101(5):358–64.PubMed
38.
Pestronk RM, Franks ML, REACH Team, Healthy Start Team, PRIDE Team. A partnership to reduce African American infant mortality in Genesee County. Michigan Public Health Rep. 2003;118(4):324–35.PubMedCrossRef
39.
Reitmanova S, Gustafson DL. “They can’t understand it”: Maternity health and care needs of immigrant Muslim women in St. John’s, Newfoundland. Matern Child Health J. 2008;12(1):101–11.PubMedCrossRef
40.
Stern M, Bitsko MJ. Pregnancy, childbirth, and postpartum outcomes. In: Kopala M, Keital MA, editors. Handbook of Counseling Women. Thousand Oaks, CA: Sage; 2003. p. 256–68.CrossRef
41.
Rotermann M. The impact of considering birthplace in analyses of immigrant health. Statistics Canada Health Reports. 2011;22(4):37–43. Catalogue no. 82-003-XPE.PubMed
42.
Gracie SK, Lyon AW, Kehler HL, Pennell CE, Dolan SM, McNeil DA, Siever JE, McDonald SW, Bocking AD, Lye SJ, et al. All Our Babies Cohort Study: Recruitment of a cohort to predict women at risk of preterm birth through the examination of gene expression profiles and the environment. BMC Pregnancy Childbirth. 2010;10:87.PubMedPubMedCentralCrossRef
43.
Statistics Canada. Immigration and ethnocultural diversity in Canada (Catalogue no. 99-010-X2011001). Ottawa, ON: Statistics Canada, Government of Canada; 2013.
44.
Azmier JJ, Huynh V, Molin K. Increasing Western Canadian immigration. Canada West Foundation: Calgary, AB; 2004.
45.
Statistics Canada. Canada’s ethnocultural mosaic, 2006 Census (Catalogue no. 97-562-X). Ottawa, ON: Statistics Canada, Government of Canada; 2008.
46.
Sue DW, Sue DS. Counselling the culturally different: Theory and practice. 4th ed. New York, NY: Wiley; 2003.
47.
Hagger MS, Rentzelas P, Koch S. Evaluating group member behaviour under individualist and collectivist norms: A cross-cultural comparison. Small Group Res. 2014;45(2):217–28.CrossRef
48.
Owe E, Vignoles VL, Becker M, Brown R, Smith PB, Lee SWS, Easterbrook M, Gadre T, Zhang X, Gheorghiu M, et al. Contextualism as an important facet of individualism-collectivism: Personhood beliefs across 37 national groups. J Cross Cult Psychol. 2013;44(1):24–45.CrossRef
49.
Falicov CJ. Working with transnational immigrants: Expanding meanings of family, community, and culture. Fam Process. 2007;46(2):157–71.PubMedCrossRef
50.
51.
Witt WP, DeLeire T, Hagen EW, Wichmann MA, Wisk LE, Spear HA, Cheng ER, Maddox T, Hampton J. The prevalence and determinants of antepartum mental health problems among women in the USA: A nationally representative population-based study. Archives Women’s Mental Health. 2010;13(5):425–37.CrossRef
52.
Kridli SA-O. Health beliefs and practices among Arab women. MCN Am J Matern Child Nurs. 2002;27(3):178–82.PubMedCrossRef
53.
Sagrestano LM, Feldman P, Rini CK, Woo G, Dunkel-Schetter C. Ethnicity and social support during pregnancy. Am J Community Psychol. 1999;27(6):869–98.PubMedCrossRef
54.
Stewart P. Who is kin? Family definition and African American families. J Hum Behav Soc Environ. 2007;15(2-3):163–81.CrossRef
55.
Mekonnen W, Worku A. Determinants of fertility in rural Ethiopia: The case of Butajira Demographic Surveillance System (DSS). BMC Public Health. 2011;11:782.PubMedPubMedCentralCrossRef
56.
Simpson K, Meadows G, Frances A, Patten S. Is mental health in the Canadian population changing over time? Can J Psychiatr. 2012;57(5):324–31.CrossRef
57.
Josefsson A, Berg G, Nordin C, Sydsjö G. Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand. 2001;80(3):251–5.PubMedCrossRef
58.
Bennett HA, Einarson A, Taddio A, Koren G, Einarson T. Prevalence of depression during pregnancy: Systematic review. Obstet Gynecol. 2004;103(4):698–709.PubMedCrossRef
59.
Stafford M, Newbold BK, Ross NA. Psychological distress among immigrants and visible minorities in Canada: A contextual analysis. Int J Soc Psychiatry. 2011;57(4):428–41.PubMedCrossRef
60.
Missinne S, Bracke P. Depressive symptoms among immigrants and ethnic minorities: A population based study in 23 European countries. Soc Psychiatry Psychiatr Epidemiol. 2012;47(1):97–109.PubMedCrossRef
61.
Sieberer M, Maksimović S, Ersöz B, Machleidt W, Ziegenbein M, Calliess IT. Depressive symptoms in first-and second-generation migrants: A cross-sectional study of a multi-ethnic working population. Int J Soc Psychiatry. 2012;58(6):605–13.PubMedCrossRef
62.
Statistics Canada: Canadian Community Health Survey: Mental health and well-being (Catalogue no. 82-617-XIE). Ottawa: Statistics Canada, Government of Canada; 2002.
63.
Karam EG, Mneimneh ZN, Karam AN, Fayyad JA, Nasser SC, Chatterji S, Kessler RC. Prevalence and treatment of mental disorders in Lebanon: A national epidemiological survey. Lancet. 2006;367(9515):1000–6.PubMedPubMedCentralCrossRef
64.
Kadri N, Agoub M, El Gnaoui S, Berrada S, Moussaoui D. Prevalence of anxiety disorders: A population-based epidemiological study in metropolitan area of Casablanca, Morocco. Ann General Psychiatry. 2007;6:6.CrossRef
65.
Jesse DE, Swanson MS. Risks and resources associated with antepartum risk for depression among rural southern women. Nurs Res. 2007;56(6):378–86.PubMedCrossRef
66.
Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: A systematic review. Am J Obstet Gynecol. 2010;202(1):5–14.PubMedPubMedCentralCrossRef
67.
Lee AM, Lam SK, Lau SM, Chong CSY, Chui HW, Fong DYT. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol. 2007;110(5):1102–12.PubMedCrossRef
68.
Westdahl C, Milan S, Magriples U, Kershaw TS, Rising SS, Ickovics JR. Social support and social conflict as predictors of prenatal depression. Obstet Gynecol. 2007;110(1):134–40.PubMedPubMedCentralCrossRef
69.
Newbold BK. Self-rated health within the Canadian immigrant population: Risk and the healthy immigrant effect. Soc Sci Med. 2005;60(6):1359–70.PubMedCrossRef
70.
Romans S, Cohen M, Forte T. Rates of depression and anxiety in urban and rural Canada. Soc Psychiatry Psychiatr Epidemiol. 2011;46(7):567–75.PubMedCrossRef
71.
Liu J, Hanley AJG, Young TK, Harris SB, Zinman B. Characteristics and prevalence of the metabolic syndrome among three ethnic groups in Canada. Int J Obesity. 2005;30(4):669–76.CrossRef
72.
Smylie J, Anderson M. Understanding the health of Indigenous peoples in Canada: Key methodological and conceptual challenges. Can Med Assoc J. 2006;175(6):602–2.CrossRef
73.
Cox JL, Chapman G, Murray D, Jones P. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women. J Affect Disord. 1996;39(3):185–9.PubMedCrossRef
74.
Ware JE, Kosinski MM, Keller SD. A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33.PubMedCrossRef
75.
76.
Moser A, Andreas E, Stuck RA, Silliman PA, Ganz K, Clough-Gorr M. The eight-item modified Medical Outcomes Study Social Support Survey: Psychometric evaluation showed excellent performance. J Clin Epidemiol. 2012;65(10):1107–16.PubMedPubMedCentralCrossRef
77.
Cohen S, Williamson GM. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, editors. The social psychology of health. Newbury Park, CA: Sage; 1988. p. 31–67.
78.
Lee E-H. Review of the psychometric evidence of the Perceived Stress Scale. Asian Nurs Res (Korean Soc Nurs Sci). 2012;6(4):121–7.CrossRef
79.
Spielberger CD, Gorsuch RL, Lushene RE. Test manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.
Metadata
Title
Who is distressed? A comparison of psychosocial stress in pregnancy across seven ethnicities
Authors
Alexandra M. Robinson
Karen M. Benzies
Sharon L. Cairns
Tak Fung
Suzanne C. Tough
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-1015-8

Other articles of this Issue 1/2016

BMC Pregnancy and Childbirth 1/2016 Go to the issue

Research article

Ureaplasma parvum genotype, combined vaginal colonisation with Candida albicans, and spontaneous preterm birth in an Australian cohort of pregnant women

Research article

Prevalence and incidence of domestic violence during pregnancy and associated risk factors: a longitudinal cohort study in the south of Sweden

Research article

Determinants of stillbirths in Ghana: does quality of antenatal care matter?

Research article

Qualitative exploration of facilitating factors and barriers to use of antenatal care services by pregnant women in urban and rural settings in Pakistan

Research article

Sleeping patterns of Swedish women experiencing a stillbirth between 2000–2014 - an observational study

Research article

Delivering care under uncertainty: Swiss providers’ experiences in caring for women with spinal cord injury during pregnancy and childbirth – an expert interview study