The Ups and Downs of Prenatal Stress: Implications for Early Parenting and Relational Health

Summary: We examine whether day-to-day lability in prenatal stress, measured through ecological momentary assessment and physiological biosensing, predicts responsive parenting and caregiver-child relational health at approximately one year postpartum.

Abstract

Prenatal stress is associated with less responsive parenting; however, the patterning of prenatal stress, such as day-to-day changes in stress experience (stress lability), has not been examined in relation to parenting and caregiver-child relational outcomes. We utilized innovative multi-level repeated measure methods to characterize stress lability during pregnancy ascertained by (a) maternal self-report via Ecological Momentary Assessment (EMA) and (b) physiological measurement using biosensing and tested if these measures predicted observed and self-reported responsive parenting and dyadic connectedness at approximately one year better than single-point measures.

Participants (n=72) were recruited in the Midwest USA and were predominantly White (79%), non-Hispanic (87%), with a graduate degree (63%). For EMA-based patterns, lower prenatal stress lability, but not baseline stress, was associated with more responsive parenting and better dyadic relationship quality in measures of observed behavior. In contrast, physiological stress lability and average physiological stress were not associated with observed mother-child interactions. Self-reported parenting measures were unrelated to EMA and physiological stress.

These findings reveal a mutable and observable mechanism that can be incorporated into prenatal stress interventions to improve outcomes in two generations. Larger, more representative studies designed a priori to test multilevel mechanisms can shed light on the varied patterns elucidated here.