title: Psychosocial Stress During First Pregnancy Predicts Infant Health Outcomes in the First Postnatal Year.
abstract: OBJECTIVE
  To evaluate the impact of psychosocial stress during pregnancy on infant health outcomes in the first postnatal year.
  
  
  METHODS
  A sample of 3000 women completed a stress inventory (the Psychosocial Hassles Scale) during their third trimester before first childbirth. Infant health outcomes were measured via maternal report at 1, 6 and 12 months postpartum. Poisson regression was used to model the effect of maternal stress during pregnancy on infant health outcomes in the first year, controlling for age, race/ethnicity, education, insurance coverage, marital status, and cigarette smoking during pregnancy.
  
  
  RESULTS
  Women who were younger, minority, unmarried, publicly insured and without a college degree were more likely to report high levels of prenatal stress. High prenatal stress was a significant predictor of maternal reporting of gastrointestinal illness (p < 0.0001), respiratory illness (p = 0.025), and total illness in the first year (p < 0.0001). High prenatal stress was also a significant predictor of urgent care visits (p < 0.0001) and emergency department visits (p = 0.001). It was not a significant predictor of hospitalizations (p = 0.36).
  
  
  CONCLUSIONS
  Maternal prenatal stress is associated with increased maternal reporting of infant illness, as well as increased frequency of both urgent care visits and emergency department visits.
authors.affiliation: Department of Public Health Sciences, College of Medicine, Penn State University, 90 Hope Drive, Hershey, PA, 17033, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Phelan
authors.affiliation: Department of Public Health Sciences, College of Medicine, Penn State University, 90 Hope Drive, Hershey, PA, 17033, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: DiBenedetto
authors.affiliation: Department of Public Health Sciences, College of Medicine, Penn State University, 90 Hope Drive, Hershey, PA, 17033, USA.
authors.forename: I M
authors.initials: IM
authors.lastname: Paul
authors.affiliation: Department of Public Health Sciences, College of Medicine, Penn State University, 90 Hope Drive, Hershey, PA, 17033, USA.
authors.forename: J
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Public Health Sciences, College of Medicine, Penn State University, 90 Hope Drive, Hershey, PA, 17033, USA. khk2@psu.edu.
authors.forename: K H
authors.initials: KH
authors.lastname: Kjerulff
mesh_terms: D005260:Female; D020073:Gravidity; D006801:Humans; D007223:Infant; D000068104:Infant Health / Q000592:standards*; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*
keywords: Health care utilization; Infant health; Pregnancy; Prenatal stress; Urgent care