Project Grant F31AT013548

TRAJECTORIES OF MATERNAL STRESS AND MINDFULNESS IN PREGNANCY: CONSEQUENCES FOR MATERNAL HEALTH AND BIRTH OUTCOMES - PROJECT SUMMARY/ABSTRACT STRESS DURING PREGNANCY CONTRIBUTES TO POOR MATERNAL HEALTH AND ADVERSE BIRTH OUTCOMES, SUCH AS PRETERM BIRTH AND LOW BIRTH WEIGHT. PREGNANT INDIVIDUALS EXPOSED TO PSYCHOSOCIAL RISK FACTORS, SUCH AS INTIMATE PARTNER VIOLENCE (IPV), ARE ESPECIALLY VULNERABLE TO STRESS AND ITS CONSEQUENCES. HOWEVER, EVIDENCE ON HOW THE TIMING AND TYPE OF PRENATAL STRESS AFFECT MOTHERS AND INFANTS HAS BEEN MIXED. FEW STUDIES ASSESS BOTH PSYCHOLOGICAL AND PHYSIOLOGICAL STRESS, AND EVEN FEWER INCLUDE POPULATIONS LIKELY TO EXPERIENCE HIGH LEVELS OF STRESS. MOREOVER, THE EXTENT TO WHICH MODIFIABLE RESILIENCE FACTORS CAN MITIGATE STRESS DURING THIS CRITICAL PERIOD REMAINS UNCLEAR. THEORY AND EXTANT RESEARCH SUGGEST THAT MINDFULNESS, HYPOTHESIZED AS A STRESS BUFFER, MAY BE A KEY PSYCHOLOGICAL RESOURCE. YET MINDFULNESS RELIES ON EXECUTIVE FUNCTIONS, WHICH MAY BE DIMINISHED IN PREGNANCY, AND NO STUDIES TO DATE HAVE MODELED CHANGES IN DISPOSITIONAL MINDFULNESS ACROSS GESTATION OR EXAMINED HOW THESE CHANGES RELATE TO MATERNAL HEALTH AND BIRTH OUTCOMES. THE OBJECTIVE OF THIS F31 IS TO IDENTIFY SUBGROUPS AND EXAMINE TRAJECTORIES OF STRESS AND MINDFULNESS DURING PREGNANCY, AND TO TEST WHETHER MINDFULNESS BUFFERS THE IMPACT OF PRENATAL STRESS ON MATERNAL HEALTH AND BIRTH OUTCOMES. THE SPECIFIC AIMS ARE TO: (1) IDENTIFY SUBGROUPS AND MODEL TRAJECTORIES OF PRENATAL STRESS ACROSS PREGNANCY USING PERCEIVED AND PHYSIOLOGICAL STRESS IN RELATION TO MATERNAL HEALTH AND BIRTH OUTCOMES; (2) IDENTIFY SUBGROUPS AND MODEL TRAJECTORIES OF MINDFULNESS ACROSS PREGNANCY IN RELATION TO MATERNAL HEALTH AND BIRTH OUTCOMES; AND (3) EXAMINE MINDFULNESS AS A MODERATOR (I.E., STRESS BUFFER) OF THE ASSOCIATION BETWEEN PRENATAL STRESS AND MATERNAL HEALTH AND BIRTH OUTCOMES. USING A SAMPLE OF N = 210 PREGNANT WOMEN SEEKING PRENATAL CARE WITH HISTORIES OF IPV, THIS F31, A NOVEL EXTENSION OF A PARENT R01, INCORPORATES ADDITIONAL MEASURES OF MATERNAL MINDFULNESS AND WELL-BEING AND USES ADVANCED STATISTICAL METHODS. AIMS WILL BE INVESTIGATED VIA GROWTH MIXTURE MODELING AND LONGITUDINAL MULTILEVEL STRUCTURAL EQUATION MODELING. FINDINGS WILL ADVANCE UNDERSTANDING OF HETEROGENEITY IN PRENATAL STRESS AND THE PROTECTIVE ROLE OF MINDFULNESS, PROVIDING CRITICAL EVIDENCE TO INFORM MORE TARGETED AND TIMELY INTERVENTIONS TO REDUCE STRESS AND RELATED MATERNAL AND INFANT HEALTH DISPARITIES. THE PROPOSED F31 SUPPORTS THE CANDIDATE'S LONG-TERM GOAL OF IDENTIFYING AND IMPLEMENTING EVIDENCE-BASED PREVENTION AND INTERVENTION STRATEGIES TO IMPROVE MATERNAL AND INFANT HEALTH, PARTICULARLY AMONG POPULATIONS VULNERABLE TO ADVERSITY. THE TRAINING GOALS ARE TO: (A) DEVELOP KNOWLEDGE AND GAIN EXPERIENCE IN COLLECTING AND ANALYZING PHYSIOLOGICAL DATA; (B) ACQUIRE EXPERTISE IN LONGITUDINAL ANALYSES THAT ARE VARIABLE- AND PERSON-CENTERED; AND (C) FOSTER SKILLS IN COMMUNITY-BASED PARTICIPATORY RESEARCH AND MINDFULNESS-BASED INTERVENTIONS WITH POPULATIONS VULNERABLE TO RISK. THE TRAINING AND DEVELOPMENT ACTIVITIES WILL PREPARE THE CANDIDATE TO LAUNCH HER CAREER AS AN INDEPENDENT BIOMEDICAL SCIENTIST, CAPABLE OF CONDUCTING RIGOROUS RESEARCH AND EFFECTIVELY COLLABORATING WITH COMMUNITIES TO TRANSLATE FINDINGS ON THE EFFECTS OF STRESS AND MINDFULNESS IN THE PRENATAL PERIOD INTO PRACTICE TO PROMOTE MATERNAL AND INFANT HEALTH.