Relationships among stress coping styles and pregnancy complications among women exposed to Hurricane Katrina

Abstract

Objective: To examine the relationship between maternal stress exposure, stress coping styles, and pregnancy complications.

Design: Quantitative, cross-sectional, and prospective study.

Setting: Tulane-Lakeside Hospital, New Orleans, LA and Women's Hospital, Baton Rouge, LA.

Participants: The study included 146 women (122 from New Orleans and 24 from Baton Rouge), who were pregnant during or immediately after Hurricane Katrina.

Methods: Participants were interviewed regarding their hurricane experiences and perceived stress, and coping styles were assessed using the Brief COPE. Medical charts were also reviewed to obtain information about pregnancy outcomes. Logistic regression was performed to determine possible associations.

Results: Hurricane exposure was significantly associated with induction of labor (adjusted odds ratio [aOR] = 1.39; 95% confidence interval [CI] [1.03, 1.86], P = .03) and current perceived stress (aOR = 1.50, CI [1.34, 1.99], P < .01). Stress perception significantly predisposed to pregnancy-induced hypertension (aOR = 1.16, CI [1.05, 1.30], P < .01) and gestational diabetes (aOR = 1.13, CI [1.02, 1.25], P = .03). Use of planning, acceptance, humor, instrumental support, and venting coping styles were associated with a significantly reduced occurrence of pregnancy complications (P < .05). Higher rates for gestational diabetes was found among women using the denial coping style (aOR = 2.25, CI [1.14, 4.45], P = .02).

Conclusion: Exposure to disaster-related stress may complicate pregnancy, whereas some coping styles may mitigate its effects. Further research should explore how coping styles may mitigate or exacerbate the effect of major stressors and how positive coping styles can be encouraged or augmented.

Keywords: Hurricane Katrina; cesarean; coping styles; gestational diabetes; induction of labor; pregnancy-induced hypertension; stress.