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Institute
Objectives:
Mothers of young children have been identified as a particularly vulnerable group during the COVID-19 pandemic. We aimed to explore how occupational, psychosocial and partnership-related factors were associated with their self-reported mental well-being during the first COVID-19 wave.
Methods:
Five hundred fifty participants of the BaBi cohort study (est. 2013, Bielefeld, North-Rhine Westphalia, Germany) were invited to complete an online survey and to take part in email interviews (April–May 2020). With survey data, we assessed self-reported mental well-being through validated instruments (eight-item Patient Health Questionnaire; short version of the Symptom Checklist) and ran linear regression models for occupational, psychosocial and partnership-related factors. We performed content analysis on the interviews’ data to further understand the determinants of the women’s mental well-being.
Results:
One hundred twenty-four women participated in the survey; of which 17 also participated in the interviews. A perceived lack of support in childcare was associated with higher levels of depressive symptoms, while having a higher internal locus of control was associated with lower levels. Psychological distress was higher in those reporting lack of emotional or childcare support. Interviews confirmed the interplay of potential stressors and highlighted the difficulties to reconcile different expectations of motherhood.
Discussion:
Occupational, psychosocial and partner-related factors can act (to varying degree) both as resources and stressors to the self-reported mental well-being of mothers of young children. These impacts took different forms and created opportunities or challenges, depending on specific life circumstances, such as work or family situations, relationships and own psychosocial resources. Although not representative, our study contributes to building the COVID-19 evidence base, delineating the mental health toll of the pandemic on mothers of young children and the factors that contribute to it.
Namensbasierte Identifizierung von Fällen mit türkischer Herkunft im Kinderkrebsregister Mainz
(2006)
Pflege türkischer Migranten
(2008)
Obwohl die Bevölkerungsgruppe mit türkischem Migrationshintergrund in Deutschland zur Zeit noch ein vergleichsweise niedriges Durchschnittsalter aufweist,
wächst der Anteil älterer Menschen unter den türkischen Migrantinnen und Migranten. Vor diesem Hintergrund gewinnen Fragen zur Pflegeversorgung dieser Bevölkerungsgruppe stark an Bedeutung, über die bisher in Deutschland kaum wissenschaftlich abgesicherte Erkenntnisse existieren. Das folgende Kapitel beschreibt die besondere Situation von Menschen mit türkischem Migrationshintergrund, die in Deutschland leben, und gibt so erste Einblicke in dieses noch junge aber wichtige Forschungsfeld und stellt einen Einstieg in die weitere Forschung zu diesem Thema dar.
Arbeitsunfälle, Berufskrankheiten und Erwerbsminderung bei Menschen mit Migrationshintergrund
(2013)
Migration und Gesundheit
(2016)
Deutschland ist ein Zuwanderungsland. Hier lebende Menschen mit Migrationshintergrund sollten den gleichen Zugang zu gesundheitsbezogenen Leistungen haben wie die gesamte Bevölkerung. Es bestehen jedoch noch Zugangshindernisse sowie Unterschiede im Nutzungsverhalten und bei den gesundheitlichen Ergebnissen. Diversity Management wird als eine Strategie diskutiert, um unterschiedliche Bedarfe und Bedürfnisse zu berücksichtigen und gesundheitliche Chancengleichheit zu erreichen.
Elevated stress during pregnancy in women of Turkish origin: Results from a prospective cohort study
(2022)
Background
Ethnic health disparities exist in the context of pregnancy and childbirth, suggesting that women of Turkish origin (i.e., they or their parents born in Turkey) in Germany have higher risks for some adverse maternal health and child developmental outcomes. Stress is believed to be a relevant pathway by which migration may be associated with these risks. In this study, we tested associations of Turkish origin with stress biology and psychological stress experiences during pregnancy.
Methods
140 pregnant women (33 of Turkish/26 of other origin) participated in a prospective cohort study that was carried out in Bielefeld and Berlin (Spallek et al., 2020). Inflammatory markers CRP and IL-6 from venous blood samples and diurnal cortisol profiles from salivary cortisol samples were derived and participants completed the Perceived Stress Scale (PSS) and Center for Epidemiologic Studies Depression Scale (CESD) at two study visits during pregnancy (T1: 20-25 weeks of gestation, T2: 30-35 weeks of gestation). Multilevel models were conducted to account for the nested data structure due to repeated measurements.
Results
Compared to non-migrant women, women of Turkish origin had significantly higher inflammatory levels (b = 0.28, SE = 0.14, p=.052) (Spallek et al., 2021), a blunted cortisol awakening response (b=-0.21, CI=-0.38–0.03, p<.05), a flatter diurnal cortisol slope (b = 0.02, CI = 0.00-0.04, p<.05), and higher PSS (b = 0.46, SE = 0.13, p< .001) and CESD scores (b = 0.29, SE = 0.08, p<.001) during pregnancy after adjusting for socioeconomic factors.
Conclusions
The results of our study suggest higher stress at the biological and psychological level in pregnant women of Turkish origin. Stress is a risk factor for pregnancy complications and poor birth and child developmental outcomes. To reduce such unequally distributed risks, interventions for stress reduction are needed that are tailored to women of Turkish origin.
Background
Immigrants from Turkey experience health disadvantages relative to non-immigrant populations in Germany that are manifest from the earliest stages of the lifespan onwards and are perpetuated across generations. Chronic stress and perturbations of stress-responsive physiological systems, including the hypothalamus-pituitary-adrenal (HPA)-axis, are believed to in part mediate this relationship. Cortisol plays an important role in the association between maternal stress during pregnancy and many pregnancy-, birth- and offspring-related outcomes. We therefore examined whether maternal migrant background is associated with diurnal cortisol variation during pregnancy.
Methods
109 pregnant women (incl. n = 32 Turkish origin women) that participated in a multi-site prospective cohort study in Germany collected saliva samples across the day on two consecutive days around 24 and 32 weeks gestation. Hierarchical linear models were applied to quantify associations between migrant background and diurnal cortisol variation across pregnancy.
Results
Women of Turkish origin exhibited a significantly lower cortisol awakening response (CAR) and a flatter diurnal cortisol slope (DCS) compared to non-migrant women after adjusting for household income. These relationships between migrant status and diurnal cortisol variation were mainly driven by 2nd generation migrants.
Discussion
A potential HPA axis dysregulation of Turkish-origin pregnant women may contribute to the intergenerational transmission of health disadvantages in this group.
Migration und Geschlecht
(2015)
Migration und Gesundheit
(2015)