Inequities in maternal stressful life events between Indigenous and non-Indigenous women - evidence from a prospective cohort study in New Zealand

Experiences of major, stressful life events (SLE) prior to and during pregnancy, and in early childhood, are associated with a range of adverse outcomes that disproportionately impact Indigenous women and their families. However, little is known about Indigenous women's experiences of SLE . The aim of this study was to investigate: (1) inequities in the prevalence and patterning of SLE between Indigenous and non-Indigenous mothers over time, and; (2) associations between maternal SLE and ethnicity, age, socioeconomic deprivation and time. Data were from the Moe Kura prospective cohort study of 418 Indigenous Maori and 768 non-Maori women in New Zealand. Questionnaires were completed at 35-37 weeks gestation, 12-weeks postpartum, and when their child was 3-4 years of age. The prevalence of five SLE domains was estimated by ethnicity. Generalised linear mixed effects models examined associations between SLE domains and ethnicity, age, socioeconomic deprivation, and time. The prevalence of SLE was greater for Maori than non-Maori at each time point. The probability of reporting SLE increased as neighbourhood deprivation worsened. The probability of reporting SLE reduced with older age, although changes in the estimates were greater for non-Maori than Maori women. Findings show that Indigenous women experience persistent and significant inequities in SLE. Younger maternal age and greater socioeconomic deprivation explain some but not all of the inequities observed. Policies and interventions to address how colonialism and racism structure experiences of SLE for Indigenous women, including via socioeconomic deprivation, are required.