Assessing Stress in Pregnancy and Postpartum: Comparing Measures

Area of Science:

• Developmental Psychology
• Perinatal Mental Health
• Child Psychiatry

Background:

• Assessing early-life psychosocial stress presents methodological challenges.
• Understanding the impact of stress timing on child emotional and behavioral difficulties (EBD) is crucial.
• This study compares three instruments for measuring life stress during pregnancy and postpartum.

Purpose of the Study:

• To compare the effectiveness of three survey instruments in assessing perinatal life stress.
• To investigate how the timing of early-life stress influences offspring EBD from childhood to adolescence.
• To identify optimal methods for predicting long-term child behavioral outcomes.

Main Methods:

• Utilized data from 4811 pregnancies in the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ).
• Assessed life stress using the Edinburgh Postnatal Depression Scale (EPDS), a stressful life events (SLE) count, and a perceived stressfulness-weighted SLE measure at three perinatal time points.
• Measured child EBD with the Strengths and Difficulties Questionnaire from age 7 to 18 years.

Main Results:

• All stress measures independently predicted long-term EBD in offspring.
• A combined model using EPDS and SLE provided the best data fit for predicting EBD.
• The impact of SLEs on EBD diminished from early pregnancy to postpartum, while the effect of EPDS increased.

Conclusions:

• Stressful life event (SLE)-based methods capture unique aspects of perinatal stress beyond psychological distress (EPDS).
• Combining psychological distress and SLE measures offers an optimal approach for predicting child EBD.
• SLE measures are best suited for early pregnancy, while self-reported depressive symptoms (EPDS) may be more effective postpartum.