Longitudinal Evaluation of Syndemic Risk Dyads in a Cohort of Young Pregnant Couples

Purpose: The burden of syndemics-which are clusters of overlapping risk factors that adversely impact health-has been previously evaluated among high-risk individuals, yet little is known regarding syndemics within the relationship context.

Methods: We evaluated concordant and discordant syndemic profiles among 296 pregnant couples and their actor-partner effects longitudinally from pregnancy to 1-year postpartum.

Results: Syndemic score and severity were correlated across all time points for men and women. There was a significant difference in syndemic score (β_Men-Women = .2736, p = <.0001) and severity (β_Men-Women = .4282, p = <.0001) during pregnancy. For actor effects, we found score (β_T1-T2 = .273, p = .002; β_T2-T3 = .300, p = .005) and severity (β_T1-T2 = .253, p = .004; β_T2-T3 = .418, p = .001) were significantly associated across all time points for women. For men, only syndemic score predicted subsequent score at later time points (β_T1-T2 = .393, p = <.001; β_T2-T3 = .421, p = <.001). Severity was not significantly associated across time (β_T1-T2 = .043, p = .566; β_T2-T3 = .172, p = .066). For partner effects, we found women's syndemic risk to influence men's syndemic risk, while men had no significant effect on women's syndemic risk.

Conclusions: Pregnancy provides an opportunity to reduce syndemic burden among men and women. Couples-based prevention programs may serve to reduce syndemic risk for both partners, particularly during the postpartum period.