Maternal health disparities linked to stressful life events: a cross-sectional study of industrialized Italian cities

Abstract

Background: Understanding the impact of family life stressors on maternal health is crucial, particularly in highly industrialized areas. This study assessed the validity of an Italian-language version of the Crisis in Family Systems-Revised (CRISYS-R) survey in Northern and Southern Italian cohorts. Methods: Mothers (n = 252) completed an Italian version of CRISYS-R, translated from English using the forward-backward method. At least 14 days after initial survey completion, a random subset of mothers (n = 44) retook CRISYS-R. Information about family demographics, socioeconomic status, and maternal health were collected by self-report on structured surveys. Statistical analyses were performed in R. Results: Test-retest analysis yielded a Pearson coefficient of 0.714 (Brescia: 0.845, Taranto: 0.726). Cronbach’s alpha coefficient for internal consistency was 0.765 (Brescia: 0.718, Taranto: 0.784). In multivariable regression, the total number of stressors reported on the initial CRISYS-R test was positively associated with: poor maternal mental health (p < 0.001), poor maternal physical health (p < 0.01), and residence in Southern rather than Northern Italy (p = 0.02). Univariate correlations yielded similar results, plus a negative correlation between annual family income and total life stressors (p < 0.05). Conclusions: Statistical analyses support the validity and reliability of an Italian-language CRISYS-R in industrialized areas, while highlighting relationships between family stress and maternal mental and physical health. This survey instrument has the potential to inform public health policies and interventions serving families in Italian-speaking areas with high burdens of industrial pollution.