Grant: Project Grant

We seek to understand the association between emotional distress during pregnancy, biological measures of emotional distress, and preterm (early) birth (PTB) in a low- and middle-income countries (LMIC). Emotional distress, refers to high levels anxiety, depression, and perceived stress that affects all cultures but is evident more so in those who are economically and socially disadvantaged. Emotional distress places pregnant women at increased risk for giving birth too early and negatively affects their well-being and that of their infants. Programs designed to treat and prevent emotional distress in pregnant women in LMIC are built on research from high-income countries, where the context and populations are very different, thus can result in unexpected harmful or negative outcomes. The risk of emotional distress among South Asian immigrant women who represent one-fifth of Canada's female population remains unchanged regardless of how long they have lived in Canada. Our study is novel as we characterize emotional distress and measure composite biological marker responses in some of the most extreme socio-economic and cultural conditions, and examine pathways through which each factor in combination may lead to PTB. We will measure Pakistani women's emotional distress through trained field researchers using interview format or handing-out and assisting when appropriate and by collecting blood samples to test biological responses at different times in pregnancy (ie, 10-19 weeks' gestation and 22-29 weeks' gestation). We will follow them to birth to determine whether their babies were born early (<37 weeks' gestation). Our findings will help clinicians and the health care system develop targeted interventions and policies that can more effectively manage emotional distress of Pakistani women both in LMIC and in Canada. Our understanding of psychosocial pathways to PTB will inform future research to examine how psychosocial interventions reduce risk of PTB.