Contextualized Stress, Global Stress, and Depression in Well-Educated, Pregnant, African-American Women

Purpose: Well-educated, pregnant, African-American women are disproportionately at risk for adverse birth outcomes and depression linked to stress has been established as a significant contributor to poor birth outcomes. Since racial and gendered stress have been identified as threats to birth outcomes, a cross-sectional study was conducted that utilized the Jackson, Hogue, Phillips Contextualized Stress Measure (JHP), a measurement of racial and gendered stress, and the Perceived Stress Scale (PSS), an assessment of global stress, to detect their associations and predictions for depression as measured by the Beck Depression Inventory II (BDI-II). Method: We recruited 101 pregnant, well-educated, African-American women from ob-gyn offices who were administered the JHP, the PSS, and the BDI-II. Correlational, chi-square, and stepwise regression analyses were conducted with the measures and the demographic variables of relationship status, the presence of other children, and annual household income. Findings: The results revealed significant linear and covariate associations for the JHP, PSS, and BDI-II. Correspondingly, chi-square analysis found significant associations for the JHP and the BDI-II and the presence of other children, relationship status, and annual household income. Results from the regression models found that the contextualized and global stress measures were both predictive of depression. Demographic characteristics did not predict depression. Conclusion: The results argue for prenatal depression and stress screening. Furthermore, the link between contextualized stress and depression alerts health care providers and local communities to be responsive to the particular stressors that pose risks for pregnant African-American women and their babies. Copyright (C) 2012 by the Jacobs Institute of Women's Health. Published by Elsevier Inc.