Social relationships, stress and infection risk in mother and child
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This thesis draws on theoretical orientations and conceptual models of how social networks, the quality of social relationships and stressful conditions, are linked to physiological responses which can influence health and behaviour. The original contribution of this work was to add to the existing literature on the links between social relationships and health, by showing the degree to which couples’ relationship dissatisfaction during pregnancy is associated with the risk of infectious diseases in both mother and children. Additionally, the project provided empirical data to a relatively new theoretical contribution to this field of research, by investigating a hypothesis derived from social baseline theory. The project includes three research articles published in peer-reviewed journals. All three articles are based on data from the Norwegian Mother and Child Cohort Study, a prospective population-based pregnancy cohort study conducted by the Norwegian Institute of Public Health. The first paper tested a hypothesis derived from social baseline theory. This theory gives a basis for understanding the impacts of social relationships on the regulation of metabolic resources. A hypothesis derived from social baseline theory is that relative social isolation leads to increased sugar intake. The present results supported this hypothesis by showing that perceived loneliness was associated with elevated intake of sugar-containing beverages. In contrast, high relationship satisfaction levels, marriage, supportive friends and a sense of togetherness at work were negatively associated with the intake of sugar-sweetened beverages. These associations remained statistically significant after controlling for scores for body mass index, weight-related self-image, depression, physical activity, educational level, age and income. Moreover, this pattern of associations was not found when sugary beverages were replaced with artificially sweetened beverages as outcome-variables, suggesting that sugar was the key component responsible for the associations between social factors and sugarcontaining beverages. The second paper explored the association between levels of relationship satisfaction and risk of infectious diseases among pregnant women. In addition, it examined whether relationship satisfaction interacted with the association between stressful life events and risk of infectious diseases during pregnancy. The results showed that, after controlling for socioeconomic factors and stressful life events, higher levels of relationship satisfaction at gestational week 15 were associated with a lower risk for 8 of 9 categories of infectious diseases during gestational weeks 17–30. Additionally, the results showed a positive association between the level of stressful life events and infectious diseases. However, no interaction effect was found between relationship satisfaction and stressful life events on the risk of infections. The third paper investigated the degree to which relationship dissatisfaction and stressful life events during pregnancy predicted risk for 8 categories of infectious diseases in children during their first year of life. The results showed that maternal relationship dissatisfaction was associated with increased risk for all tested infectious diseases among infants less than 6 months old and increased risk for 7 categories of diseases among 6–12-month-old children. The associations remained statistically significant after adjusting for scores for socioeconomic factors, prenatal stressful life events, smoking, maternal depression, breastfeeding, child’s sex and use of childcare. It was also found that maternal stressful life events were associated with 7 of 8 groups of diseases in both age groups of children. Finally, the results showed that pregnant women who experienced higher degrees of relationship dissatisfaction and higher numbers of stressful life events reported a higher frequency and greater variety of infectious diseases in their children. Overall, this work supports that couples’ relationship dissatisfaction during pregnancy is associated with the risk of infectious diseases in both mother and children. Additionally, it provides support for social baseline theory by demonstrating that loneliness, relationship quality, and other social factors were associated with the level of consumption of sugary beverages. Thus, the project provided empirical data to a relatively new theoretical contribution to the field of research concerned with how social relationships are linked to physiological responses which in turn have the potential of influencing health and behaviour.
Has partsPaper I: Henriksen RE, Torsheim T, Thuen F (2014) Loneliness, social integration and consumption of sugar-containing beverages: testing the social baseline theory. PLoS One 9: e104421. The article is available at: http://hdl.handle.net/1956/9572
Paper II: Henriksen RE, Torsheim T, Thuen F (2015) Relationship satisfaction reduces the risk of maternal infectious diseases in pregnancy: the Norwegian Mother and Child Cohort Study. PLoS One 10: e0116796. The article is available at: http://hdl.handle.net/1956/9673
Paper III: Henriksen RE, Thuen F (2015) Marital quality and stress in pregnancy predict the risk of infectious disease in the offspring: the Norwegian Mother and Child Cohort Study. PLoS One 10: e0137304. The article is available at: http://hdl.handle.net/1956/13064