Assessment of Maternal Stress in Pregnant African American Women during the Second Trimester

Abstract

Key Words: Stress, Anxiety, Pregnancy, African American women

Objective: The purpose of this study was to assess levels of maternal stress in African American (AA) women during the second trimester and identify patterns that may have implications for care.

Design:  A prospective 12 week longitudinal study using three repeated measures.

Setting:  AA women were recruited from an academic obstetrical service and a community obstetrical practice located in Southeastern Virginia.

Participants: 27 African American women between 14 and 17 weeks EGA who met the inclusion criteria provided informed consent.Main Outcome Measures:  Measures included the Perceived Stress Scale, Numeric Rating of Scale of Stress, State Anxiety Inventory, and Center for Epidemiologic Studies (CES-D)
Results:  Pregnant AA women during the second trimester demonstrated high levels of stress and anxiety compared to published mean sample scores of pregnant and non-pregnant samples.  Perceived stress remained consistently high and anxiety levels increased during the second trimester.  The daily stress scores remained consistent throughout the 12 weeks reflecting the chronic nature of stress the women were experiencing. At all three time points, the CES-D means scores suggested a significant level of psychological distress.

Conclusions:  Patterns of perceived stress and anxiety in AA pregnant women during the second trimester are concerning as they are risk factors for preterm birth. The results of this study suggest nurses should assess stress levels at the initial prenatal visit and throughout pregnancy; provide stress reduction strategies; collaborate with health care partners to provide case management services; and ensure there is a referral mechanism for mental health services.

Models of prenatal care targeted to meet identified needs should be explored.