The purpose of this physiological, cross sectional, correlational study is two-fold: (1) to document the relationships among the variables of daily stressor, emotional distress, and physiological stress in pregnant women, and, (2) to document the relationship between maternal stress and poor birth outcomes. Maternal stress is defined as daily stressors, emotional distress, and physiological stress. Daily stressors are defined as the number of daily events reported as stressful by subjects. Emotional distress is defined as self-report anxiety, anger, and depression. Physiological stress is defined as the levels of urinary catecholamines and salivary immunoglobulin A (IgA). Poor birth outcomes are defined as preterm birth and low birth weight infants. Ninety low-income African- American women between 32 and 34 weeks gestation attending prenatal clinic at a university affiliated hospital perinatal center will be entered into the study. Women will be asked to complete four questionnaires: a demographic sheet, the Daily Hassles scale, the Spielberger State Anxiety Inventory, and the Profile of Mood State Inventory. After completion of the questionnaires, physiological stress will be measured by asking subjects to obtain a saliva specimen (IgA) in the clinic and a 12-hour urine specimen (urinary catecholamines) over the PM hours at home the evening upon entering the study. Laboratory procedures for the measurement of physiological stress will include: (1) high performance Liquid chromatography with electrochemical detection for urinary catecholamines, and (2) enzyme-linked immunosorbant assay for salivary IgA. Date analysis will include Pearson Product Moment Correlational analyses and multiple regression to test the hypotheses. This study addresses the significant perinatal health problem of infant mortality and morbidity. Preterm birth and low birth weight remain the leading cause of mortality and morbidity in infants. This study will make a vital contribution to understanding the psychoneuroimmunology of maternal stress on poor birth outcomes with the potential for developing subsequent programs of research to test cost-effective interventions to mediate maternal stress and improve infant mortality and morbidity.
