Neighbourhood Socioeconomic Disparity in Exposure to Preterm Birth Risk During the Pandemic: Secondary Analysis of Pregnancy During the Pandemic Cohort

Jung, Won Kyu

Neighbourhood Socioeconomic Disparity in Exposure to Preterm Birth Risk During the Pandemic: Secondary Analysis of Pregnancy During the Pandemic Cohort

dc.contributor.advisor	Tomfohr-Madsen, Lianne
dc.contributor.author	Jung, Won Kyu
dc.contributor.committeemember	Giesbrecht, Gerald
dc.contributor.committeemember	Chaput, Kathleen
dc.date	2023-11
dc.date.accessioned	2023-09-28T16:45:05Z
dc.date.available	2023-09-28T16:45:05Z
dc.date.issued	2023-09-17
dc.description.abstract	Background: Preterm birth (PTB) is defined as a live birth before 37 weeks of gestation and remains a major public health concern, affecting an estimated 15 million births annually with a global prevalence of 11%. Socioeconomic disparities play a crucial role in PTB rates, with both individual- and neighborhood-level factors contributing. Stress response pathway has been identified as a key mechanism in the relationship between neighborhood socioeconomic status (nSES) and PTB risk. As such, the new challenges added due to the COVID-19 pandemic, such as disruption to the support networks and increased psychosocial distress for pregnant individuals, were expected to increase PTB rates. However, studies found lack of change or even decrease in the incidence during this period. It is suggested that such counter intuitive findings are due to lack of consideration for the differential exposure to the pandemic-related hardships based on nSES. Therefore, the primary aim of the present study is to test whether a measure of objective pandemic hardship and psychological distress mediate the relationship between nSES and PTB. Methods: Present study is a secondary analysis of the data collected from a prospective longitudinal cohort study, Pregnancy during the Pandemic (PdP). Two serial mediation path models with a measure of baseline objective pandemic hardship and psychological distress included as mediators between nSES and PTB/gestational age (GA) were tested. Results: In both models, the main indirect pathway of interest from nSES to pandemic objective hardship, psychological distress, then PTB/GA was non-significant with minimal effect. Secondary indirect pathway of interest from pandemic objective hardship to psychological distress then PTB/GA was significant in both models while controlling for months into the pandemic at birth and baseline sociodemographic characteristics. Discussion: The present paper is the first to test a comprehensive model of the role of nSES on PTB risk with an explicit measure of pandemic objective hardship and psychological distress included as mediators. While the main indirect serial mediation pathway was non-significant, partial support for the proposed mechanism was observed where increase in pandemic-related hardship elevated psychological distress, which then heightened the risk of PTB risk and shortened gestational age at birth.
dc.identifier.citation	Jung, W. K. (2023). Neighbourhood socioeconomic disparity in exposure to preterm birth risk during the pandemic: secondary analysis of pregnancy during the pandemic cohort (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.uri	https://hdl.handle.net/1880/117280
dc.language.iso	en
dc.publisher.faculty	Arts
dc.publisher.institution	University of Calgary
dc.rights	University 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.
dc.subject	Neighbourhood
dc.subject	Socioeconomic Disparity
dc.subject	Pregnancy
dc.subject	Preterm Birth
dc.subject	Pandemic
dc.subject	COVID-19
dc.subject.classification	Education--Health
dc.subject.classification	Mental Health
dc.subject.classification	Psychology--Clinical
dc.subject.classification	Psychobiology
dc.title	Neighbourhood Socioeconomic Disparity in Exposure to Preterm Birth Risk During the Pandemic: Secondary Analysis of Pregnancy During the Pandemic Cohort
dc.type	master thesis
thesis.degree.discipline	Psychology – Clinical
thesis.degree.grantor	University of Calgary
thesis.degree.name	Master of Science (MSc)
ucalgary.thesis.accesssetbystudent	I do not require a thesis withhold – my thesis will have open access and can be viewed and downloaded publicly as soon as possible.