Examining Neighbourhood Socioeconomic Status, Anxiety and Depression during Pregnancy, and Preterm Birth

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dc.contributor.advisorMetcalfe, Amy
dc.contributor.advisorPatten, Scott B.
dc.contributor.authorAdhikari Dahal, Kamala
dc.contributor.committeememberWilliamson, Tyler S.
dc.contributor.committeememberPatel, Alka B.
dc.date2019-11
dc.date.accessioned2019-07-15T14:47:54Z
dc.date.available2019-07-15T14:47:54Z
dc.date.issued2019-07-10
dc.description.abstractBackground: Understanding of influence of anxiety, depression, and neighbourhood socioeconomic status (SES) on the risk of preterm birth (PTB) is unclear. This doctoral research examined the ability of neighbourhood SES to predict the risk of PTB, the utility of existing anxiety scales in measuring anxiety in pregnancy, and whether neighbourhood SES modified the association between anxiety and depression during pregnancy and PTB. Methods: This study used data from two pregnancy cohort studies in Alberta, Canada (n=5,528). The data were linked to neighbourhood SES data, derived from the Canadian census. A multilevel logistic regression prediction model was developed to examine whether neighbourhood SES improves the prediction of PTB. Confirmatory factor analysis and Spearman correlation were used to examine the utility of anxiety scales in pregnancy. A multivariable logistic regression model was used to assess whether neighbourhood SES modifies the association between anxiety and/or depression and PTB. Results: Neighbourhood level variance explained PTB by 6%. Neighbourhood SES combined with maternal characteristics predicted PTB with an area under the receiver operating characteristic curve (AUC) of 0.75. Maternal characteristics alone had AUC of 0.60. The model fit of anxiety scales ranged from inadequate to adequate. The correlation between the scales was low to moderate. The presence of both anxiety and depression, but neither anxiety nor depression alone, was significantly associated with PTB (OR=1.57, 95% CI=1.07, 2.29) and had significant interaction with neighbourhood deprivation (p-value=0.014). Conclusions: This research may suggest that women’s neighbourhood SES improves overall prediction of PTB and that it modifies the effects of anxiety and depression on risk of PTB. It may also indicate that existing anxiety scales do not measure anxiety as a single dimension and they are incomparable. These findings may guide the identification of women at increased risk for PTB and future research in the field.en_US
dc.identifier.citationAdhikari Dahal, K. (2019). Examining Neighbourhood Socioeconomic Status, Anxiety and Depression during Pregnancy, and Preterm Birth (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/36745
dc.identifier.urihttp://hdl.handle.net/1880/110638
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectAnxiety and depressionen_US
dc.subjectNeighbourhood socioeconomic statusen_US
dc.subjectPregnancyen_US
dc.subjectPreterm birthen_US
dc.subjectPredictionen_US
dc.subjectValidityen_US
dc.subjectFactor analysisen_US
dc.subjectAnxiety scalesen_US
dc.subject.classificationEpidemiologyen_US
dc.titleExamining Neighbourhood Socioeconomic Status, Anxiety and Depression during Pregnancy, and Preterm Birthen_US
dc.typedoctoral thesisen_US
thesis.degree.disciplineMedicine – Community Health Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameDoctor of Philosophy (PhD)en_US
ucalgary.item.requestcopytrueen_US
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