Financial strain and birth weight: the mediating role of psychological distress

Arch Womens Ment Health. 2017 Feb;20(1):201-208. doi: 10.1007/s00737-016-0696-3. Epub 2016 Dec 13.


The effects of financial strain during pregnancy have received limited attention. In addition, data examining the pathways by which SES indicators contribute to birth weight are lacking. The objective of the current study was to examine the potential pathway of psychological distress in the relationship between financial strain and birth weight. Participants consisted of 138 pregnant women who completed measures assessing financial strain, depressive symptoms, pregnancy-specific distress, perceived stress, and general anxiety during pregnancy (mean gestational age = 18.5, SD = 7.2). Birth outcome data were obtained via medical record review. Simple and parallel mediation models were conducted using PROCESS. Simple mediation models showed that depressive symptoms (95% CI -24.65, -0.90) and pregnancy-specific distress (95% CI -37.31, -5.91), but not perceived stress (95% CI -31.17, 4.69) or anxiety (95% CI -25.84, 5.57), served as mediators in the relationship between financial strain and birth weight. When depressive symptoms and pregnancy-specific distress were included in the same mediation model, only pregnancy-specific distress remained significant. Financial strain was positively associated with all facets of psychological distress and negatively associated with birth weight during pregnancy. The current study demonstrated the mechanistic role of pregnancy-specific distress in the link between financial strain and birth weight in a racially diverse sample. Interventions targeting pregnancy-specific distress may mitigate the effects of financial strain on birth weight. Studies examining whether pregnancy-specific distress accounts for the relationship between other types of stressor exposures and birth weight would be informative.

Keywords: Birth weight; Depressive symptoms; Financial strain; Mediation; Pregnancy; Pregnancy-specific distress.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anxiety / economics
  • Anxiety / psychology*
  • Birth Weight*
  • Depression
  • Female
  • Gestational Age
  • Humans
  • Poverty*
  • Pregnancy
  • Pregnancy Complications / psychology
  • Socioeconomic Factors*
  • Stress, Psychological / economics
  • Stress, Psychological / psychology*