Do Successive Preterm Births Increase the Risk of Postpartum Depressive Symptoms?

Background. Postpartum depression and preterm birth (PTB) are major problems affecting women’s health. PTB has been associated with increased risk of postpartum depressive symptoms (PDS). However, it is unclear if PTB in women with a prior history of PTB is associated with an incremental risk of PDS. This study aims to determine if PTB in women with a prior history of PTB is associated with an incremental risk of PDS. Methods. Data come from the 2009–2011 national Pregnancy Risk Assessment Monitoring System. Study sample included 55,681 multiparous women with singleton live births in the index delivery. Multiple logistic regression was used to examine the association between PTB and PDS. Results. The risk of PDS was 55% higher in women with PTB in both deliveries (aRR = 1.55; 95% CI = 1.28–1.88) and 74% higher in women with PTB in the index delivery only (aRR = 1.74; 95% CI = 1.49–2.05), compared to women with term deliveries. Conclusions. Preterm birth is a risk factor for PDS. PTB in women with a prior history of PTB is not associated with an incremental risk of PDS. Routine screening for PDS should be conducted for all women and closer monitoring should be done for high risk women with PTB

The Impact of Mother–Father Relationship, Social Support and Neighborhood Context on Preterm Birth

Background: Preterm birth is a major public health concern in the US. Previous studies have suggested that quality of the mother-father relationship, social support, and neighborhood violence may be associated with preterm birth; however, findings are equivocal. Objectives: The main objectives of this dissertation were: 1) to determine the modifying effect of perceived residential environment on the association between quality of mother–father relationship and preterm birth in a sample of African-American women, 2) to examine whether the receipt of social support modifies the association between neighborhood violence exposure and preterm birth in a nationally representative sample of US women, and 3) to determine the extent to which neighborhood violence mediates the association between neighborhood deprivation and preterm birth in a geographic cohort of women in Richmond city, Virginia. Methods: Data were obtained from three sources – 1) Life-course Influences on Fetal Environments (LIFE) study, 2) National Longitudinal Study of Adolescent to Adult Health, and 3) live birth records, police crime reports and census data for Richmond city, Virginia. Multivariable log-binomial regression models were used to examine the modifying effect of perceived residential environment on the association between quality of mother–father relationship and preterm birth, as well as the modifying effect of social support on the association between neighborhood violence exposure and preterm birth. Multilevel structural equation modeling was used to examine the mediational influence of neighborhood violence on the association between neighborhood deprivation and preterm birth. Results: For the association between neighborhood violence exposure and preterm birth, maternal receipt of social support modified the association [(Tertile 1: adjusted prevalence ratio (APR)=1.12; 95% CI=1.11-1.13, p\u3c.0001); (Tertile 2: APR=1.07; 95% CI=1.06-1.08, p\u3c.0001); and (Tertile 3: APR=0.88; 95% CI=0.86-0.89, p\u3c.0001)] in a nationally representative sample of US women. No significant interaction was observed between any domain of the mother–father relationship and perceived maternal residential environment (all p \u3e 0.05) in a sample of African American women. Additionally, no significant association was found between the quality of mother–father relationship and preterm birth (Trust domain: APR=1.03, 95% CI=0.99-1.07; dependability domain: APR=1.01, 95% CI=0.98-1.06; criticism domain: APR=1.03, 95% CI=0.99-1.07). The association between neighborhood deprivation and preterm birth in a geographic cohort of women in Richmond city, Virginia, was not mediated by neighborhood violence (β=0.063, 95% CI= –0.025, 0.151). Conclusions: Rates of preterm birth in women exposed to neighborhood violence may be improved by providing adequate social support during the pregnancy period. Insufficient evidence was found to support the modifying effect of perceived residential environment on the association between the mother-father relationship and preterm birth, as well as the mediational effect of neighborhood violence on the association between neighborhood deprivation and preterm birth. Future studies are needed to confirm these findings

Do Successive Preterm Births Increase the Risk of Postpartum Depressive Symptoms?

Background. Postpartum depression and preterm birth (PTB) are major problems affecting women's health. PTB has been associated with increased risk of postpartum depressive symptoms (PDS). However, it is unclear if PTB in women with a prior history of PTB is associated with an incremental risk of PDS. This study aims to determine if PTB in women with a prior history of PTB is associated with an incremental risk of PDS. Methods. Data come from the 2009-2011 national Pregnancy Risk Assessment Monitoring System. Study sample included 55,681 multiparous women with singleton live births in the index delivery. Multiple logistic regression was used to examine the association between PTB and PDS. Results. The risk of PDS was 55% higher in women with PTB in both deliveries (aRR = 1.55; 95% CI = 1.28-1.88) and 74% higher in women with PTB in the index delivery only (aRR = 1.74; 95% CI = 1.49-2.05), compared to women with term deliveries. Conclusions. Preterm birth is a risk factor for PDS. PTB in women with a prior history of PTB is not associated with an incremental risk of PDS. Routine screening for PDS should be conducted for all women and closer monitoring should be done for high risk women with PTB

Racial/Ethnic Differences in the Modifying Effect of Community Violence on the Association between Paternity Status and Preterm Birth

Preterm birth (PTB) is a major public health concern in the US. Lack of established paternity has been linked with increased risk of PTB. Community violence (CV) may modify the association, and racial/ethnic differences may exist. Using a geographically defined cohort of women in Richmond, Virginia (N = 27,518), we examined racial/ethnic differences in the modifying effect of CV on the association between paternity status and PTB. Results showed that lack of established paternity was associated with incremental greater odds of PTB across CV quartiles in NH-Whites (quartile-1: AOR = 1.42, 95% CI = 0.95–2.12; quartile-2: AOR = 1.45, 95% CI = 0.57–3.71; quartile-3: AOR = 3.12, 95% CI = 2.67–6.32), NH-Blacks (quartile-1: AOR = 1.16, 95% CI = 0.85–1.58; quartile-2: AOR = 1.32, 95% CI = 0.82–2.12; quartile-3: AOR = 1.64, 95% CI = 1.24–2.16), and Hispanics (quartile-1: AOR = 1.29, 95% CI = 0.65–2.55; quartile-2: AOR = 1.34, 95% CI = 0.67–2.69). Odds of PTB were highest among NH-White women. Public health practitioners should be aware of the negative effect of lack of paternal presence on PTB in women resident in high violence rate communities and racial/ethnic differences that exist

Association between vaccination beliefs and COVID-19 vaccine uptake in a longitudinal panel survey of adults in the United States, 2021–2022

COVID-19 vaccine hesitancy has been a major limiting factor to the widespread uptake of COVID-19 vaccination in the United States. A range of interventions, including mass media campaigns, have been implemented to encourage COVID-19 vaccine confidence and uptake. Such interventions are often guided by theories of behavior change, which posit that behavioral factors, including beliefs, influence behaviors such as vaccination. Although previous studies have examined relationships between vaccination beliefs and COVID-19 vaccination behavior, they come with limitations, such as the use of cross-sectional study designs and, for longitudinal studies, few survey waves. To account for these limitations, we examined associations between vaccination beliefs and COVID-19 vaccine uptake using data from six waves of a nationally representative, longitudinal survey of U.S. adults (N = 3,524) administered over a nearly 2-year period (January 2021–November 2022). Survey-weighted lagged logistic regression models were used to examine the association between lagged reports of vaccination belief change and COVID-19 vaccine uptake, using five belief scales: (1) importance of COVID–19 vaccines, (2) perceived benefits of COVID-19 vaccination, (3) COVID-19 vaccine concerns and risks, (4) normative beliefs about COVID-19 vaccination, and (5) perceptions of general vaccine safety and effectiveness. Analyses controlled for confounding factors and accounted for within-respondent dependence due to repeated measures. In individual models, all vaccination belief scales were significantly associated with increased COVID-19 vaccine uptake. In a combined model, all belief scales except the benefits of COVID-19 vaccination were significant predictors of vaccine uptake. Overall, belief scales indicating the importance of COVID-19 vaccines and normative beliefs about COVID-19 vaccination were the strongest predictors of COVID-19 vaccine uptake. Findings demonstrate that changes in vaccination beliefs influence subsequent COVID-19 vaccine uptake, with implications for the development of future interventions to increase COVID-19 vaccination