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Cultural and Psychobiological Processes in Pregnant Latina Women

  • Author(s): Ramos, Isabel Francheska
  • Advisor(s): Dunkel Schetter, Christine
  • et al.
Abstract

Research indicates that women who experience higher levels of anxiety related to a current pregnancy have a higher risk of preterm birth (Blackmore, Gustafsson, Gilchrist, Wyman, & O’Connor, 2016; Dunkel Schetter, 2010). Previous studies demonstrate that pregnancy anxiety is associated with higher levels of placental corticotropin-releasing hormone (pCRH) which in turn, triggers the timing of delivery. Some evidence suggests that Latinas experience heightened pregnancy anxiety (Ramos et al., 2019), but no study has documented their specific experiences of pregnancy anxiety.

This dissertation tested a model that incorporates components of biopsychosocial and cultural processes in pregnancy across two studies. The first study examined ethnic and cultural moderation linking pregnancy anxiety to the length of gestation in a sample of pregnant Latina and non-Latina White women (N = 125). These women completed interviews and provided blood samples on three separate occasions during their pregnancy. Pregnancy anxiety in the first, second, and third trimesters each predicted shorter length of gestation. Latina and non-Latina White women did not differ in pregnancy anxiety and had similar gestational length at birth. Moderation analyses on the full sample revealed that pregnancy anxiety was associated with gestational length for Latinas only. A similar pattern emerged in analyses on the subsample of Latinas for moderation by acculturation such that pregnancy anxiety predicted the timing of delivery only among low acculturated Latinas. Neither levels nor slopes of pCRH mediated the associations between pregnancy anxiety and length of gestation. This work adds to existing evidence that pregnancy anxiety predicts timing of birth and affirms that ethnicity and acculturation are relevant for understanding cultural and biopsychosocial processes leading to birth outcomes.

The second study used a qualitative methodology to investigate pregnancy anxiety and cultural beliefs surrounding pregnancy among Latinas. One focus group and 11 individual interviews were conducted in Spanish with pregnant Latinas. Thematic analysis (Braun & Clarke, 2006) revealed that Latinas felt that anxiety during pregnancy was normal, and that they were concerned about childbirth, losing their baby, their baby being born with a birth defect, and the current issues in the United States. Latinas felt lucky to be pregnant, believed that pregnancy was a blessing, and stressed the importance of maintaining a healthy pregnancy. Themes about family involvement and culturally-driven privileged status also emerged from the data.

Taken together, these two studies further affirm that pregnancy anxiety contributes to risk for preterm birth and adds evidence that associations of pregnancy anxiety and gestational length may be driven in part by ethnicity and by cultural factors among Latinas. Future studies using larger samples should further investigate these issues utilizing prospective designs with a closer examination of cultural processes. Such work can further identify the role of culture in prenatal processes affecting maternal and child outcomes and help to understand the nature and risks of pregnancy anxiety in Latinas.

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