Conceptualization and Assessment of Prenatal Maternal Stress in Diverse Women: A Structural Equation Modeling Approach

Ceylan Cizmeli, Stony Brook University, State University of New York (SUNY)
Marci Lobel, Stony Brook University, State University of New York (SUNY)
Audrey Saftlas, University of Iowa

Prenatal maternal stress (PNMS) is a risk factor for adverse birth outcomes and has deleterious effects on maternal and neonatal health. Numerous approaches to defining PNMS have been used to examine its health effects; however, operationalizing this construct has proven challenging to researchers. Multivariate definition of PNMS comprised of stress stimuli, responses, and appraisals is conceptually powerful but the validity of this approach among diverse women is unknown. We conducted a population-based study with a diverse sample of 2,709 women to examine the validity of a theoretically-founded, multivariate operational stress definition in one of the largest studies of PNMS to date. Using structural equation modeling, PNMS was modeled as a latent variable represented by stress stimuli, appraisals, and emotional responses. As hypothesized, the model exhibited multigroup equivalence across education, income, ethnicity, age, gravidity, employment status, and pregnancy intendedness, confirming the validity of the multivariate definition of PNMS among diverse groups.