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Psychosocial stressors and low birth weight: development of a questionnaire
1Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205.
Insights
Black women face higher risks for low birth weight (LBW) babies. A new tool, the Prenatal Social Environment Inventory, helps measure chronic stressors during pregnancy to understand these disparities.
Area of Science:
- Public Health
- Psychosocial Epidemiology
- Reproductive Health
Background:
- Low birth weight (LBW) is a significant public health concern, contributing to infant mortality and morbidity.
- Racial disparities exist, with Black women experiencing higher rates of LBW compared to White women, despite similar risk factors.
- The underlying reasons for this excess risk in Black women remain unclear, though psychosocial stressors are implicated.
Purpose of the Study:
- To develop and validate a reliable tool for assessing chronic psychosocial stressors in pregnant women.
- To address the limitations of previous research lacking adequate instruments to measure stress exposure during pregnancy.
Main Methods:
- Development of the Prenatal Social Environment Inventory (PSEI), a self-administered questionnaire.
- Conceptualization and measurement of stress exposure within the context of chronic stressful conditions.
- Psychometric evaluation including temporal stability, internal consistency, and construct validity.
Main Results:
- The Prenatal Social Environment Inventory (PSEI) demonstrated acceptable 30-day temporal stability (reliability).
- The questionnaire showed good internal consistency and construct validity.
- The PSEI is suitable for use in clinical settings with pregnant populations.
Conclusions:
- The PSEI is a valid and reliable instrument for assessing chronic psychosocial stressors in pregnant women.
- This tool can aid in understanding the role of psychosocial factors in adverse pregnancy outcomes, particularly racial disparities in LBW.
- Further research can utilize the PSEI to investigate the impact of chronic stress on maternal and infant health.
Abstract:
Low birth weight is a major public health problem because it is a major contributor to infant mortality as well as to various types of morbidity among young children. Of particular concern is that black women have an increased risk of low birth weight babies compared with white women. Many etiologic factors for low birth weight have been identified, but even within homogeneous strata of risk, black women have a greater risk of low birth weight babies than do white women. The reasons for this excess risk are not well understood. Available evidence suggests that exposure to psychosocial stressors is associated with adverse pregnancy outcomes. However, prior work in this area has been limited by the lack of a valid and reliable tool to assess exposure to stressors among pregnant women. We report on the development and testing of such a questionnaire, the Prenatal Social Environment Inventory. In this questionnaire, exposure to stressors is conceptualized and measured in the context of chronic stressful conditions. The questionnaire is self-administered and can be used in clinical settings with pregnant women. Findings of psychometric evaluations showed that the questionnaire has acceptable levels of 30-day temporal stability (reliability), internal consistency, and construct validity.