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Scholarly Works (2 results)

  • Thesis
  • Peer Reviewed
UC Irvine Electronic Theses and Dissertations (2024)

Self-rated health (SRH) is a robust indicator of mortality, morbidity, and health behaviors. Despite consisting of a single item, SRH is a comprehensive measure that captures overall health status and encompasses biological, social, and psychological factors that influence health. Predictors of SRH across these domains are not well understood, particularly among young healthy individuals. Using a biopsychosocial approach, this dissertation explored in three separate studies biological markers of systems implicated in stress physiology (i.e., immune, autonomic, and endocrine), social determinants of health, and psychological factors that are relevant to SRH. Study 1 (N = 99) showed that higher levels of salivary (p = .011) and serum (p = .013) inflammatory markers predicted higher odds of reporting poor SRH, highlighting that inflammation is associated with worse SRH. Study 2 (N = 148) explored whether cardiovascular reactivity to stress, indexing activity of the sympathetic nervous system, and discrimination, a social determinant of health, were related to SRH. The study showed that increases in pre-ejection period (PEP) reactivity were associated with a 2% greater chance of reporting better SRH. Findings for the association between discrimination and SRH differed based on the participants’ ethnicity. Study 3 (N = 50) investigated endocrine markers in relation to SRH and documented that higher levels of placental corticotropin releasing hormone (pCRH) were associated with increased odds of poor SRH (p = .046) among a sample of pregnant Latinas. Everyday discrimination (p = .005), familism (p = .021) and positive trait emotion (p = .003) predicted lower odds of poor SRH. Findings from this dissertation provide direction for further examining SRH through a biopsychosocial lens. Implications for understanding the utility of SRH as a screening tool to identify individuals at risk for poor health outcomes are discussed.

    • Article
    • Peer Reviewed
    UCLA Previously Published Works (2024)

    Objective

    Depressive symptoms following birth are common and can have adverse effects for mothers, children, and families. Changes in hypothalamic-pituitary-adrenal (HPA) axis regulation during pregnancy may be implicated in the development of postpartum depressive symptoms, particularly changes in placental corticotropinreleasing hormone (pCRH). However, few studies have tested how dynamic pCRH changes over pregnancy relate to postpartum depressive symptoms. This preregistered investigation tests associations of both pCRH levels and changes from early to late pregnancy with postpartum depressive symptoms.

    Methods

    The sample consists of 173 women studied in early, mid, and late pregnancy who later reported on depressive symptoms with the Edinburgh Postpartum Depression Scale during interviews at 1, 6 and 12 months postpartum. Blood samples were collected at each prenatal timepoint and assayed for pCRH using radioimmunoassay. Latent growth curve analysis was employed to identify distinct trajectories of pCRH during pregnancy.

    Results

    We identified three prenatal pCRH trajectories labeled as typical, flat, and accelerated. Each trajectory showed exponential increases in pCRH levels over the course of gestation but differed in overall levels and rates of change. pCRH levels were not associated with postpartum depressive symptoms. However, women with accelerated pCRH trajectories reported marginally higher depressive symptoms one month postpartum. Primary analysis models adjusted for marital status, income, prepregnancy BMI, parity, prenatal depressive symptoms, and gestational age.

    Conclusions

    These findings add to our understanding of dynamic changes to maternal HPA axis regulation during pregnancy and contribute to growing evidence on how pCRH changes relate to the development of postpartum depressive symptoms.
      Cover page: Placental corticotrophin-releasing hormone trajectories in pregnancy: Associations with postpartum depressive symptoms
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