Date of Award

Spring 6-12-2026

Document Type

Dissertation

Degree Name

Ph.D. in Psychology

Organizational Unit

College of Arts Humanities and Social Sciences, Psychology

First Advisor

Jenalee R. Doom

Second Advisor

Elysia Poggi Davis

Third Advisor

Julia Dmitrieva

Fourth Advisor

Kamilah B. Legette

Copyright Statement / License for Reuse

All Rights Reserved
All Rights Reserved.

Keywords

Cardiovascular disease (CVD), Psychosocial experiences, Maternity, Discrimination, Post-partum

Abstract

Cardiovascular disease (CVD) is the leading cause of death among women, yet how psychosocial experiences across the life course contribute to early maternal cardiovascular risk is not well-understood. Pregnancy and the years following childbirth represent a critical window for identifying emerging cardiometabolic vulnerability. The primary goals of this dissertation were to examine how childhood experiences and everyday discrimination during pregnancy are associated with maternal CVD risk factors assessed at 3-4 years postpartum.

This dissertation addressed these aims through two independent, prospective studies conducted using a longitudinal cohort of 223 individuals recruited during pregnancy and followed through 3-4 years postpartum. Study 1 examined whether everyday discrimination during pregnancy, often a chronic psychosocial stressor, was associated with maternal CVD risk factors (body mass index [BMI], waist circumference, body fat percentage, systolic and diastolic blood pressure, arterial stiffness, and a composite CVD risk index). Study 2 examined whether adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) were associated with the same cardiovascular outcomes and tested whether obstetric complications (e.g., hypertensive disorders of pregnancy, preterm birth, etc.) mediated these associations.

In Study 1, linear regression analyses found that greater everyday discrimination during pregnancy was significantly associated with higher arterial stiffness at 3-4 years postpartum, even after controlling for sociodemographic factors and other stressful life events during pregnancy. Everyday discrimination was not associated with BMI, waist circumference, body fat percentage, blood pressure, or composite CVD risk. In Study 2, greater ACEs were consistently associated with higher composite CVD risk, BMI, waist circumference, body fat percentage, systolic blood pressure, and arterial stiffness in adjusted models. Greater PCEs were associated with lower arterial stiffness, but not other outcomes. Obstetric complications did not mediate associations between childhood experiences and cardiovascular risk, although they were independently associated with multiple CVD risk factors.

Together, these findings suggest that early experiences and psychosocial stressors during pregnancy are associated with maternal cardiovascular health in the years following childbirth through distinct patterns. ACEs were broadly linked to greater CVD risk, whereas everyday discrimination during pregnancy and PCEs were specifically associated with arterial stiffness in opposite directions. These results highlight the importance of a life course perspective for understanding maternal cardiovascular risk and highlight pregnancy and the years following childbirth as key windows for early identification and prevention.

Copyright Date

6-2026

Publication Statement

Copyright is held by the author. User is responsible for all copyright compliance.

Rights Holder

Nathalie Dieujuste

Provenance

Received from ProQuest

File Format

application/pdf

Language

English (eng)

Extent

149 pgs

File Size

2.2 MB

Download

Available for download on Sunday, July 09, 2028



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