Preterm delivery (PTD) and prenatal depression are major public health problems. Previous studies suggest that socioeconomic position (SEP) has been negatively associated with the risk of PTD and mental health problems. However, the association between maternal socioeconomic mobility (SM) and the risk of PTD or prenatal depression is rarely investigated. We hypothesized that women with low childhood SEP and low adulthood SEP will be at greatest risk of PTD or prenatal depression; upward SM from childhood to adulthood will lower women’s risk of PTD or prenatal depression; and downward SM from childhood to adulthood will increase risk of PTD or prenatal depression. We aimed (1) to evaluate the relationship between maternal SM and risk of PTD; and (2) to assess the association between maternal SM and risk of prenatal depression in a Michigan, community-based cohort study that is racially and socioeconomically diverse. Because other studies reported that the relation of SEP (or SM) with risk of PTD or prenatal depression varied by maternal race/ethnicity, we also examine evidence for this effect modification.Data were collected from 3,019 pregnant women recruited from 5 Michigan communities at mid-trimester (16-27 weeks’ gestation) in the Pregnancy Outcomes and Community Health (POUCH) Study (1998-2004). Pregnant women provided their parents’ SEP indicators (education, occupation, receipt of public assistance) and their own and child’s father’s SEP indicators (education, occupation, Medicaid status, and household income) at enrollment. PTD was defined as deliveries less than 37 completed weeks’ gestation. Prenatal depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D) and CES-D≥16 was defined as high CES-D. Latent class analysis was conducted to identify latent groups of childhood SEP indicators, adulthood SEP indicators, and SM from childhood to adulthood, respectively. A model-based approach to latent class analysis with distal outcome assessed relations between latent class and PTD or prenatal depression, overall and within race/ethnicity groups. Three latent groups (low, middle, high) were identified for childhood SEP indicators and adulthood SEP indicators, respectively; while four latent groups (static low, upward, downward, and static high) best described SM. Women with upward SM had decreased odds of PTD (odds ratio (OR)=0.60, 95% confidence interval (CI): 0.42, 0.87), compared to those with static low SEP. Women with upward SM had decreased odds of high CES-D (OR=0.22, 95% CI: 0.17, 0.29), compared to those with static low SEP. Women in downward group had elevated odds of high CES-D (OR=4.13, 95% CI: 2.75, 6.22), compared to those in static high group. This SM advantage was true for white/other women for PTD and most pronounced in white/other women for high CES-D. Maternal experiences of upward SM or downward SM may be important considerations when assessing risk of PTD or prenatal depression. Our results support the argument that policies and programs aimed at improving women’s SEP could lower PTD or prenatal depression risk. Our study suggests that policies or programs to increase opportunities for upward mobility may play an important role in decreasing the risk of PTD or prenatal depression. Further research is needed to understand the specific elements accompanying SM that are protective for PTD or prenatal depression and the best strategies for increasing SM among all race/ethnic groups.
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