Kelli Stidham Hall1, Yasamin Kusunoki2, Heather Gatny2, Jennifer Barber3. 1. Department of Obstetrics and Gynecology, Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, Michigan. Electronic address: hkelli@umich.edu. 2. Institute for Social Research, Population Studies and Survey Research Centers, University of Michigan, Ann Arbor, Michigan. 3. Department of Sociology, Institute for Social Research, Population Studies and Survey Research Centers, University of Michigan, Ann Arbor, Michigan.
Abstract
PURPOSE: Prior research linking young women's mental health to family planning outcomes has often failed to consider their social circumstances and the intersecting biosocial mechanisms that shape stress and depression as well as reproductive outcomes during adolescence and young adulthood. We extend our previous work to investigate relationships between social discrimination, stress and depression symptoms, and unintended pregnancy among adolescent and young adult women. METHODS: Data were drawn from 794 women aged 18-20 years in a longitudinal cohort study. Baseline and weekly surveys assessed psychosocial information including discrimination (Everyday Discrimination Scale), stress (Perceived Stress Scale), depression (Center for Epidemiologic Studies-Depression Scale), and reproductive outcomes. Multilevel, mixed-effects logistic regression and discrete-time hazard models estimated associations between discrimination, mental health, and pregnancy. Baron and Kenny's method was used to test mediation effects of stress and depression on discrimination and pregnancy. RESULTS: The mean discrimination score was 19/45 points; 20% reported moderate/high discrimination. Discrimination scores were higher among women with stress and depression symptoms versus those without symptoms (21 vs. 18 points for both, p < .001). Pregnancy rates (14% overall) were higher among women with moderate/high (23%) versus low (11%) discrimination (p < .001). Discrimination was associated with stress (adjusted relative risk ratio, [aRR], 2.2; 95% confidence interval [CI], 1.4-3.4), depression (aRR, 2.4; CI, 1.5-3.7), and subsequent pregnancy (aRR, 1.8; CI, 1.1-3.0). Stress and depression symptoms did not mediate discrimination's effect on pregnancy. CONCLUSIONS: Discrimination was associated with an increased risk of mental health symptoms and unintended pregnancy among these young women. The interactive social and biological influences on reproductive outcomes during adolescence and young adulthood warrant further study.
PURPOSE: Prior research linking young women's mental health to family planning outcomes has often failed to consider their social circumstances and the intersecting biosocial mechanisms that shape stress and depression as well as reproductive outcomes during adolescence and young adulthood. We extend our previous work to investigate relationships between social discrimination, stress and depression symptoms, and unintended pregnancy among adolescent and young adult women. METHODS: Data were drawn from 794 women aged 18-20 years in a longitudinal cohort study. Baseline and weekly surveys assessed psychosocial information including discrimination (Everyday Discrimination Scale), stress (Perceived Stress Scale), depression (Center for Epidemiologic Studies-Depression Scale), and reproductive outcomes. Multilevel, mixed-effects logistic regression and discrete-time hazard models estimated associations between discrimination, mental health, and pregnancy. Baron and Kenny's method was used to test mediation effects of stress and depression on discrimination and pregnancy. RESULTS: The mean discrimination score was 19/45 points; 20% reported moderate/high discrimination. Discrimination scores were higher among women with stress and depression symptoms versus those without symptoms (21 vs. 18 points for both, p < .001). Pregnancy rates (14% overall) were higher among women with moderate/high (23%) versus low (11%) discrimination (p < .001). Discrimination was associated with stress (adjusted relative risk ratio, [aRR], 2.2; 95% confidence interval [CI], 1.4-3.4), depression (aRR, 2.4; CI, 1.5-3.7), and subsequent pregnancy (aRR, 1.8; CI, 1.1-3.0). Stress and depression symptoms did not mediate discrimination's effect on pregnancy. CONCLUSIONS: Discrimination was associated with an increased risk of mental health symptoms and unintended pregnancy among these young women. The interactive social and biological influences on reproductive outcomes during adolescence and young adulthood warrant further study.
Authors: A S Khashan; R McNamee; K M Abel; P B Mortensen; L C Kenny; M G Pedersen; R T Webb; P N Baker Journal: Hum Reprod Date: 2008-12-03 Impact factor: 6.918
Authors: Tené T Lewis; Susan A Everson-Rose; Lynda H Powell; Karen A Matthews; Charlotte Brown; Kelly Karavolos; Kim Sutton-Tyrrell; Elizabeth Jacobs; Deidre Wesley Journal: Psychosom Med Date: 2006 May-Jun Impact factor: 4.312
Authors: Julia R Steinberg; Jeanne M Tschann; Jillian T Henderson; Eleanor A Drey; Jody E Steinauer; Cynthia C Harper Journal: Contraception Date: 2013-09-09 Impact factor: 3.375
Authors: Kelli Stidham Hall; Abubakar Manu; Emmanuel Morhe; Lisa H Harris; Dana Loll; Elizabeth Ela; Giselle Kolenic; Jessica L Dozier; Sneha Challa; Melissa K Zochowski; Andrew Boakye; Richard Adanu; Vanessa K Dalton Journal: J Sex Res Date: 2017-03-07
Authors: Charvonne N Holliday; Heather L McCauley; Jay G Silverman; Edmund Ricci; Michele R Decker; Daniel J Tancredi; Jessica G Burke; Patricia Documét; Sonya Borrero; Elizabeth Miller Journal: J Womens Health (Larchmt) Date: 2017-04-12 Impact factor: 2.681
Authors: Serena MacDonald; Leslie R M Hausmann; Florentina E Sileanu; Xinhua Zhao; Maria K Mor; Sonya Borrero Journal: Med Care Date: 2017-09 Impact factor: 2.983
Authors: Sneha Challa; Abubakar Manu; Emmanuel Morhe; Vanessa K Dalton; Dana Loll; Jessica Dozier; Melissa K Zochowski; Andrew Boakye; Richard Adanu; Kelli Stidham Hall Journal: Women Health Date: 2017-04-03
Authors: Soudabeh Fazeli Dehkordy; Kelli S Hall; Vanessa K Dalton; Ruth C Carlos Journal: J Womens Health (Larchmt) Date: 2016-07-18 Impact factor: 2.681
Authors: Jessica L Li; William Kilembe; Mubiana Inambao; Bellington Vwalika; Rachel Parker; Tyronza Sharkey; Ana-Maria Visoiu; Lisa B Haddad; Kristin M Wall; Susan Allen Journal: Am J Obstet Gynecol Date: 2020-01-14 Impact factor: 8.661
Authors: Kamila A Alexander; Tiara C Willie; Raegan McDonald-Mosley; Jacquelyn C Campbell; Elizabeth Miller; Michele R Decker Journal: J Interpers Violence Date: 2019-07-11