Prenatal negative affect states and reproductive health outcomes: The mediating role of health behaviors

Women's experience of negative affect (i.e. distress, anxiety and depression) during pregnancy has been linked to their physical health and the health of their babies; however, the variables mediating this link are not fully understood. Health behaviors, specifically physical exercise, dietary intake, alcohol consumption, and cigarette smoking, were hypothesized to mediate the link between negative affect and health during pregnancy. Eighty pregnant women were followed from their first trimester through delivery, and they completed study measures on three occasions, once for each trimester. The sample was primarily White and middle class. Negative affect data were collected via mailed questionnaires including the Beck Depression Inventory (BDI) and the Mood and Anxiety Symptom Questionnaire (MASQ). Health behavior data were collected via telephone interviews. Data reflecting maternal and neonatal physical health were obtained from medical records. Independent sample t-tests indicated that pregnant smokers experienced greater anhedonia and distress than non-smokers, but smoking was not related to any health outcomes. At a significance level of .05, no variables met criteria for the hypothesized mediating model. Negative affect was not related to any health outcomes. Higher anxiety and distress levels were related to greater dietary calcium intake, and calcium was also positively related to infant birthweight. Leisure physical activity was related to greater gestational age at birth. Caffeine consumption was positively related to maternal health and negatively related to birthweight. Changes in affect and health behaviors across trimesters were explored. Additional analyses of relationships between life events and other study variables were reported. Evidence for the mediating role of health behaviors was not found. Lack of findings may be due to characteristics of the sample including low medical risk, low levels of negative affect and few deleterious health behaviors. To further understanding of the links among negative affect, behavior, and physical health during pregnancy, future research should include clinically depressed women and women from low-income and ethnic minority groups.