Date of Degree

2-2016

Document Type

Dissertation

Degree Name

D.P.H.

Program

Public Health

Advisor(s)

Mary Clare Lennon

Jennifer Dowd

Committee Members

Jennifer Dowd

Heidi Jones

Trace Kershaw

Subject Categories

Maternal and Child Health

Keywords

birth outcomes, stress, low birth weight, preterm birth, relationships, fathers

Abstract

This dissertation consists of three studies exploring the effects of maternal and paternal experiences of stress and perceptions of relationship quality on length of gestation and birth weight. The first study assessed the association of parental relationship quality with the baby’s length of gestation and birth weight among 2,072 families in the Fragile Families and Child Wellbeing study. Romantic relationships can be a substantial source of social support as well as stress, and have been shown to influence many health outcomes. Beyond crude relationship characteristics, however, few studies have assessed the association of other dimensions of relationship quality, such as conflict and support, with birth outcomes. No studies have assessed the association of father’s report of relationship quality with birth outcomes. In this study, multilevel linear regression analyses found that babies born to fathers who were present at their birth were born significantly heavier and had a longer gestation. The results also showed that greater paternal relationship conflict was associated with lower gestational age among all couples and lower birth weight among unmarried couples.

The second study investigated the association between parental stress during pregnancy with their baby’s length of gestation and birth weight among a sample of 270 young couples in southern Connecticut. Many studies have shown that women’s experiences of stress during pregnancy are associated with preterm birth and low birth weight; however, men’s experiences have largely been ignored. Structural equation modeling of the association between maternal and paternal stress latent variables and birth outcomes showed that greater paternal stress was significantly associated with longer gestation and greater birth weight, while maternal stress was not significantly associated with these outcomes. The findings from the first two studies suggest that men’s experiences and feelings when they are expecting a baby may have a unique contribution to birth outcomes.

The third study assessed the association between parental stress during pregnancy and their own and their partner’s poor health behaviors and depressive symptoms among a sample of young couples in lower Connecticut. Many unhealthy behaviors, such as substance use, develop during adolescence and evidence shows that stress is a contributing factor. This association has not been established among pregnant adolescents and little attention has been paid to male partners. Among a sample of 294 young expectant couples, multilevel modeling showed that one’s own experiences of stress were associated with more unhealthy behaviors and depressive symptoms for both members of the couple. Cross-over effects were also evident—paternal stress was predictive of more maternal conduct problems, while maternal stress was predictive of less paternal substance use and more depressive symptoms. These findings highlight the importance of social relationships and interactions on health behaviors.

Overall, the results of the three studies suggest that father’s experiences during pregnancy matter to their baby’s health, and that experiences of stress during pregnancy may impact an expectant couples’ own and their partner’s health behaviors. This dissertation research treated men’s experiences during pregnancy, including experiences of stress and relationship quality, with equal weight to women’s experiences when it came to their impact on birth outcomes and health behaviors. Future, research, programs and policies aimed at improving birth outcomes may be strengthened by the inclusion of expectant fathers.

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