Experience of discrimination reported during pregnancy and infant's emerging effortful control.

Discrimination reported during pregnancy is associated with poorer offspring emotional outcomes. Links with effortful control have yet to be examined. This study investigated whether pregnant individuals' reports of lifetime racial/ethnic discrimination and everyday discrimination (including but not specific to race/ethnicity) reported during pregnancy were associated with offspring emerging effortful control at 6 months of age. Pregnant individuals (N = 174) and their offspring (93 female infants) participated. During pregnancy, participants completed two discrimination measures: (1) lifetime experience of racial/ethnic discrimination, and (2) everyday discrimination (not specific to race/ethnicity). Parents completed the Infant Behavior Questionnaire-Revised when infants were 6 months old to assess orienting/regulation, a measure of emerging effortful control. Analyses were conducted in a subsample with racially/ethnically marginalized participants and then everyday discrimination analyses were repeated in the full sample. For racially/ethnically marginalized participants, greater everyday discrimination (ß = -.27, p = .01) but not greater lifetime experience of racial/ethnic discrimination (ß = -.21, p = .06) was associated with poorer infant emerging effortful control. In the full sample, greater everyday discrimination was associated with poorer infant emerging effortful control (ß = -.24, p = .002). Greater perceived stress, but not depressive symptoms, at 2 months postnatal mediated the association between everyday discrimination and emerging effortful control. Further research should examine additional biological and behavioral mechanisms by which discrimination reported during pregnancy may affect offspring emerging effortful control.

Sociocultural stressors across the perinatal period and risk for postpartum depressive symptoms in women of Mexican descent.

OBJECTIVES: In the United States, women of Mexican descent are affected by postpartum depression at disproportionate rates, often two to three times higher than the general population. Sociocultural stressors may contribute to this disparity. Traditionally, these stressors are measured at a single time point, and it is unknown if sociocultural stressors change from pregnancy to the postnatal period and if they are related to postpartum depressive symptoms. METHOD: Pregnant women of Mexican descent (N = 159) were assessed for acculturation (Mexican and Anglo orientation), perceived discrimination, acculturative stress, perceived stress, and depressive symptoms during the first trimester and postpartum period. RESULTS: Women reported increases in Mexican orientation, t(126) = -3.503, p = .01, and decreases in acculturative stress, t(159) = -3.503, p < .001, and perceived stress, t(159) = 6.332, p < .001, from pregnancy to postpartum. Only increases in Mexican orientation were associated with less postpartum depressive symptoms (R² = 0.050, B = -2.210, SE = 0.996, t = -2.120, p = .028), even when controlling for covariates. In addition, postnatal measurements of elevated acculturative stress and less Mexican orientation (R² = 0.127, B = 0.133, SE = 0.036, t = 3.721, p < .001; B = -2.194, SE = 0.769, t = -2.853, p < .001, respectively) were associated with more postpartum depressive symptoms; however, only Mexican orientation remained significant after covariates. CONCLUSIONS: Sociocultural stressors change across the perinatal period and contribute to postpartum depressive symptoms. Findings implicate a need for consideration of sociocultural stressors in postpartum depression prevention. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Sleep Moderates and Mediates the Relationship Between Acculturation and Depressive Symptoms in Pregnant Mexican-American Women.

OBJECTIVE: Greater acculturation is associated with adverse perinatal outcomes in Mexican-American women, but the mechanisms by which acculturation influences perinatal outcomes are unclear. Pregnant acculturated Mexican-American women are more likely to engage in unhealthy prenatal behaviors relative to those less acculturated, including poor sleep. As sleep disruptions are associated with acculturation and negative perinatal outcomes, particularly maternal depression, alterations in sleep may adversely affect pregnant Mexican-American women. METHODS: Sixty pregnant women of Mexican descent completed surveys about sleep, acculturation, depressive symptoms and potential protective factor of social support. RESULTS: Acculturation, but not social support, significantly predicted increased sleep disruptions as well as overall feeling less refreshed upon waking across pregnancy. Moderation analysis indicated that more acculturated women who took longer to fall asleep reported increased depressive symptoms. Feeling refreshed upon waking also mediated the relationship between increased acculturation and elevated maternal depressive symptoms. CONCLUSIONS: Acculturation and altered sleep contribute to greater risk in Mexican-American women for maternal depressive symptoms in the perinatal period. These findings have implications for prevention and treatment of maternal mental health disorders, which may adversely affect perinatal outcomes in the vulnerable Mexican-American population.

Effects of sociocultural stressors on maternal responsivity and the infant behavioral and neuroendocrine response to stress in families of Mexican descent.

Maternal stress is consistently linked to alterations in maternal behavior and infant neurodevelopmental outcomes. As the Latino population grows in the U.S., it is increasingly important to understand how culturally relevant factors affect this relationship. This study aimed to address the role of sociocultural stressors on maternal sensitivity and markers of infant emotional regulation and the neuroendocrine response to stress in mother/infant dyads of Mexican descent. Pregnant women of Mexican descent (n = 115) were recruited during early pregnancy and followed until their infants were 6 months old. Mothers completed measures of sociocultural stressors (acculturative stress and discrimination) at pre and postnatal time points. At 6 months, dyads underwent the Still Face procedure. Mothers were observed for behaviors exhibiting maternal responsivity, while negative vocalizations were observed in infants. Salivary cortisol was also collected from infants. Maternal responsivity was a salient risk factor for alterations in infant emotional regulation and cortisol activity. Postnatal experiences of discrimination were also negatively associated with infant negative affect. This work highlights maternal responsivity and points to a potential role for experiences of discrimination in the response to stress in the mother/child dyad that may have consequences for the development of emotional regulation in infants of Mexican descent.

COVID-19-Related Risk, Resilience, and Mental Health Among Mexican American Mothers Across the First Year of the Pandemic.

BACKGROUND: Latina mothers have been especially affected by the pandemic and historically exhibit high rates of depression and anxiety. However, few longitudinal studies have assessed the effect of the pandemic on this vulnerable population. We hypothesized that COVID-19-related stressors would associate with psychological distress among Latina mothers across the first year of the pandemic. METHODS: We investigated COVID-19-related impact, stigma, and fears across two critical time points and changes in these measures in relation to changes in maternal anxiety and depression among mothers of Mexican descent living in Southern California (n=152). Surveys were administered within 5-16 weeks of the March 19, 2020 stay-at-home COVID-19 order in California and again between June to December 2021. RESULTS: High proportions of women reported moderate to severe impacts of COVID-19 early in the pandemic, which reduced modestly a year later, e.g., reduced family incomes (55.9% 2020 Lockdown vs 32.7% 1-year follow-up). Anticipatory stigma was high across the first year, e.g., worrying at least some of the time that a family member will be deported (33.1% 2020 Lockdown vs. 14.1% 1-year follow-up), or they would not be able to care for their children (88.5% 2020 lockdown vs 82.2% 1-year follow-up). COVID-19 stigma, impact, and fears were significantly associated with higher levels of anxiety and depressive symptoms at both time points (p<0.003), and changes in COVID-19 impact were associated with changes in depression (p=0.0004). CONCLUSION: Findings emphasize the adverse socioeconomic and psychological effects of the pandemic for Latina mothers.

Acculturation, maternal cortisol, and birth outcomes in women of Mexican descent.

OBJECTIVE: This study investigated the effects of acculturation on cortisol, a biological correlate of maternal psychological distress, and perinatal infant outcomes, specifically gestational age at birth and birth weight. METHODS: Fifty-five pregnant women of Mexican descent were recruited from a community hospital, and their saliva samples were collected at home for 3 days during pregnancy at 15 to 18 weeks (early), 26 to 32 weeks (mid), and more than 32 weeks (late) of gestation and once in the postpartum period (4-12 weeks). These values were used to determine the diurnal cortisol slope at each phase of pregnancy. Mothers also completed an acculturation survey and gave permission for a medical chart review to obtain neonate information. RESULTS: Multiple regression analyses determined that greater acculturation levels significantly predicted earlier infant gestational age at birth (R(2) = 0.09, p = .03). Results from t tests revealed that mothers of low-birth-weight infants (<2500 g) had significantly higher acculturation scores than mothers of infants with birth weight greater than 2500 g (t = -2.95, p = .005). A blunted maternal cortisol slope during pregnancy was also correlated with low birth weight (r = -0.29, p = .05) but not gestational age (r = -0.08, p = .59). In addition, more acculturated women had a flatter diurnal cortisol slope late in pregnancy (R(2) = 0.21, p = .01). Finally, diurnal maternal cortisol rhythms were identified as a potential mediator between increased acculturation and birth weight. CONCLUSIONS: This study associated increased acculturation with perinatal outcomes in the US Mexican population. This relationship may be mediated by prenatal maternal diurnal cortisol, which can program the health of the fetus leading to several adverse perinatal outcomes.

Changes in sociocultural stressors, protective factors, and mental health for US Latina mothers in a shifting political climate.

BACKGROUND: To investigate changes in sociocultural stressors and protective factors, and mental health in Latina mothers before and after the 2016 Republican presidential nomination. METHODS: We examined changes in sociocultural stressors, protective factors, and mental health from two prospective cohorts of Latina mothers from interior and border US cities (Nashville, TN, n = 39 and San Diego, CA, ns range = 78-83; 2013-2020). RESULTS: We identified significant longitudinal increases in depression, anxiety, and perceived stress in the border city, and reductions in protective factors (e.g., optimism, social support, and familism) across sites. Discrimination varied by location, and was associated with higher stress only at baseline in the border city, and with higher anxiety in the interior city at follow-up. Acculturative stress was consistently associated with worse mental health across time points in the border city. Various protective factors were associated with reduced stress and anxiety across time points in both cities. DISCUSSION: We identified decreased mental health at the border city, and reduced protective factors in Latina mothers across both study sites in the years following the 2016 presidential nomination, during a time of shifting sociopolitical climate. We also identify increased acculturative stress and discrimination over time, particularly at the border city. Interventions to maintain and enhance psychosocial protective factors amongst Latina mothers are warranted.

Associations between religiosity and perinatal anxiety symptoms among women of Mexican descent.

BACKGROUND: Over half of pregnant women experience anxiety symptoms, however perinatal mental health disparities exist. Women of Mexican descent exhibit higher levels of anxiety symptoms which may be linked to sociocultural stressors. However, little is known about culturally relevant factors that may protect against anxiety in this fast-growing population, such as religiosity, an important facet of Mexican culture. METHODS: Pregnant women of Mexican descent (n = 197) were recruited from a local community clinic and followed into the postpartum period. Women completed surveys assessing religiosity, acculturation, acculturative stress, and anxiety symptoms. RESULTS: Higher levels of religiosity were associated with lower levels of anxiety symptoms throughout pregnancy, but not postpartum (b = -1.01, p = .002). Additionally, religiosity significantly buffered the relationship between acculturative stress and anxiety symptoms during early (R2 = .13, b = -.12, p = .041), mid- (R2 = .19, b = -.19, p < .001) and late pregnancy (R2 = .14, b = -.13, p = .023), and at six weeks postpartum (R2 = .08, b = -.12, R2 = .08, p = .016). LIMITATIONS: The study was limited to women of Mexican descent and it is possible that other immigrant groups may exhibit different patterns of religiosity and anxiety symptoms. CONCLUSIONS: These results suggest that religiosity may be protective against maternal anxiety among women of Mexican descent, which has important implications for culturally relevant perinatal interventions and treatments.

Acculturative stress negatively impacts maternal depressive symptoms in Mexican-American women during pregnancy.

BACKGROUND: Mexican-American women exhibit high rates of prenatal maternal depressive symptoms relative to the general population. Though pregnant acculturated Mexican-American women experience cultural stressors such as acculturation, acculturative stress and discrimination that may contribute to elevated depressive symptoms, the contribution of these socio-cultural correlates to depressive symptomology is unknown. METHOD: Ninety-eight pregnant women of Mexican descent were recruited from a community hospital clinic during their first trimester. Women completed surveys about acculturation, acculturative stress, perceived discrimination, general perceived stress, and maternal depressive symptoms as well as the potential protective factor of Mexican cultural values. RESULTS: Women who experienced greater acculturative and perceived stress, but not perceived discrimination or acculturation, reported significantly elevated depressive symptoms during pregnancy. Also, women who experienced greater acculturative stress identified with a mixture of Mexican and American cultural values. However, only the Mexican cultural value of respect was protective against maternal depressive symptoms while adhering to the Anglo value of independence and self-reliance was a risk factor. LIMITATIONS: A limitation in the study is the cross-sectional and descriptive self-report nature of the work, underscoring the need for additional research. Moreover, physiological measures of stress were not analyzed in the current study. CONCLUSIONS: Results point to acculturative stress, above other cultural stressors, as a potential intervention target in culturally competent obstetric care. These findings have implications for maternal mental health treatment during pregnancy, which likely affects maternal-fetal programming and may favorably affect perinatal outcomes in the vulnerable Mexican-American population.

Paternal psychopathology and maternal depressive symptom trajectory during the first year postpartum.

Understanding parental psychopathology interaction is important in preventing negative family outcomes. This study investigated the effect of paternal psychiatric history on maternal depressive symptom trajectory from birth to 12 months postpartum. Maternal Edinburgh Postpartum Depression screens were collected at 1, 6 and 12 months and fathers' psychiatric diagnoses were assessed with the Structured Clinical Interview for DSM-IV from 64 families. There was not a significant difference in the trajectory of maternal depressive symptoms between mothers with partners with history of or a current psychiatric condition or those without a condition. However, mothers with partners with substance abuse history had higher levels of depressive symptoms relative to those affected by mood/anxiety disorders or those without a disorder. Our results call for a closer look at paternal history of substance abuse when treating postpartum maternal depression.

Hair cortisol levels as a retrospective marker of hypothalamic-pituitary axis activity throughout pregnancy: comparison to salivary cortisol.

Maternal stress during pregnancy is associated with negative maternal/child outcomes. One potential biomarker of the maternal stress response is cortisol, a product of activity of the hypothalamic-pituitary-adrenal axis. This study evaluated cortisol levels in hair throughout pregnancy as a marker of total cortisol release. Cortisol levels in hair have been shown to be easily quantifiable and may be representative of total cortisol release more than single saliva or serum measures. Hair cortisol provides a simple way to monitor total cortisol release over an extended period of time. Hair cortisol levels were determined from each trimester (15, 26 and 36 weeks gestation) and 3 months postpartum. Hair cortisol levels were compared to diurnal salivary cortisol collected over 3 days (3 times/day) at 14, 18, 23, 29, and 34 weeks gestational age and 6 weeks postpartum from 21 pregnant women. Both salivary and hair cortisol levels rose during pregnancy as expected. Hair cortisol and diurnal salivary cortisol area under the curve with respect to ground (AUCg) were also correlated throughout pregnancy. Levels of cortisol in hair are a valid and useful tool to measure long-term cortisol activity. Hair cortisol avoids methodological problems associated with collection other cortisol measures such as plasma, urine, or saliva and is a reliable metric of HPA activity throughout pregnancy reflecting total cortisol release over an extended period.