Path analysis results of the association between maternal exposure to stressful life events prior to conception and offspring overall health, special healthcare needs and severe health conditions in early childhood through very low birth weight
| Fair or poor health | Special healthcare needs | Severe health conditions | ||||
|---|---|---|---|---|---|---|
| β | 95% CI | β | 95% CI | β | 95% CI | |
| Direct effects | ||||||
| From PSLEs to VLBW | 0.55% | (0.23 to 0.87) | 0.55% | (0.23 to 0.87) | 0.55% | (0.23 to 0.87) |
| From PSLEs to CH at 9 months | −0.81% | (−1.75 to 0.14) | −0.98% | (−2.86 to 0.90) | 1.03% | (–1.27 to 3.34) |
| From PSLEs to CH at 24 months | 0.56% | (−0.48 to 1.60) | −0.44% | (−3.34 to 2.45) | 1.99% | (−0.75 to 4.73) |
| From VLBW to CH at 9 months | 5.33% | (2.97 to 7.69) | 26.53% | (22.53 to 30.53) | 8.92% | (5.91 to 11.92) |
| From VLBW to CH at 24 months | 4.10% | (2.01 to 6.19) | 21.50% | (17.50 to 25.51) | 9.04% | (5.96 to 12.12) |
| From CH at 9 months to CH at 24 months | 13.19% | (5.96 to 20.42) | 28.25% | (22.40 to 34.10) | 20.55% | (15.68 to 25.42) |
| Indirect effects* | ||||||
| PSLEs → VLBW > CH at 9 months | 0.03% | (0.01 to 0.05) | 0.15% | (0.06 to 0.24) | 0.05% | (0.01 to 0.08) |
| PSLEs > CH at 24 months | −0.08% | (−0.22 to 0.06) | −0.12% | (−0.69 to 0.46) | 0.27% | (−0.21 to 0.75) |
| PSLEs > CH at 9 months > CH at 24 months | −0.11% | (−0.25 to 0.04) | −0.28% | (−0.82 to 0.26) | 0.21% | (−0.27 to 0.70) |
| PSLEs > VLBW > CH at 24 months | 0.02% | (0.01 to 0.04) | 0.12% | (0.04 to 0.20) | 0.05% | (0.02 to 0.08) |
| PSLEs > VLBW > CH at 9 months > CH at 24 months | 0.01% | (0.00 to 0.01) | 0.04% | (0.02 to 0.07) | 0.01% | (0.00 to 0.02) |
| Model fit statistics | ||||||
| χ2 statistic and p value | 14.3 | 0.11 | 15.9 | 0.11 | 11.2 | 0.26 |
| CFI | 0.991 | 0.991 | 0.997 | |||
| RMSEA | 0.009 | 0.011 | 0.006 | |||
N=6900. Weighted estimates. β Coefficients reported as the per cent change in the probability of having each child health outcome for a 1 unit change in each independent variable. Models adjust for pregnancy complications, maternal chronic conditions, pre-pregnancy body mass index, initiation of prenatal care, plurality, parity, exposure to any stressful life event during pregnancy, maternal race/ethnicity, maternal age, marital status at birth, health insurance coverage, family socioeconomic status and US region of residence (see figure 1).
*Specific indirect effects are listed below the total indirect effects, which are in bold.
CFI, comparative fit index; CH, child health; PSLEs, stressful life events prior to conception; RMSEA, root mean square error of approximation; VLBW, very low birth weight.