The preterm prediction study: Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation

The preterm prediction study: Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation

OBJECTIVE: Our purpose was to determine whether various measures of poor psychosocial status in pregnancy are associated with spontaneous preterm birth, fetal growth restriction, or low birth weight. STUDY DESIGN: Anxiety, stress, self-esteem, mastery, and depression were assessed at 25 to 29 weeks...

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Published in:American journal of obstetrics and gynecology Vol. 175; no. 5; pp. 1286 - 1292
Main Authors: Copper, Rachel L., Goldenberg, Robert L., Das, Anita, Elder, Nancy, Swain, Melissa, Norman, Gwendolyn, Ramsey, Risa, Cotroneo, Peggy, Collins, Beth A., Johnson, Francee, Jones, Phyllis, Meier, Arlene
Format: Journal Article
Language:English
Published: Philadelphia, PA Mosby, Inc 01-11-1996
Elsevier
Subjects:
Biological and medical sciences
Diseases of mother, fetus and pregnancy
fetal growth restriction
Gynecology. Andrology. Obstetrics
low birth weight
Medical sciences
Pregnancy. Fetus. Placenta
preterm birth
Psychosocial characteristics
stress
preterm birth
stress
Psychosocial characteristics
low birth weight
fetal growth restriction
Human
Pregnancy disorders
Spontaneous
Low birth weight
Premature delivery
Gestational age
Stress
Fetal diseases
Newborn diseases
Fetal hypotrophy
Prematurity
Mother
Risk factor
Delivery disorders
Female
Psychopathology
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Summary:OBJECTIVE: Our purpose was to determine whether various measures of poor psychosocial status in pregnancy are associated with spontaneous preterm birth, fetal growth restriction, or low birth weight. STUDY DESIGN: Anxiety, stress, self-esteem, mastery, and depression were assessed at 25 to 29 weeks in 2593 gravid women by use of a 28-item Likert scale. Scores for each psychosocial subscale were determined, and an overall psychosocial score was calculated. Scores were divided into quartiles, and the lowest quartile scores were used to define poor psychosocial status. The percent spontaneous preterm birth, low birth weight, and fetal growth restriction in women with low and high psychosocial scores were compared. Logistic regression analyses provided the odds ratios and 95% confidence intervals. RESULTS: Analyses revealed that stress was significantly associated with spontaneous preterm birth and with low birth weight with odds ratios of 1.16, p = 0.003, and 1.08, p = 0.02, respectively, for each point on the scale. A low score on the combined scale or on any subscale other than stress did not predict spontaneous preterm birth, fetal growth restriction, or low birth weight. After multivariate adjustment was performed for psychosocial status, substance use, and demographic traits, black race was the only variable significantly associated with spontaneous preterm birth, fetal growth restriction, and low birth weight; stress and low education were associated with spontaneous preterm birth and low birth weight. CONCLUSION: Stress was associated with spontaneous preterm birth and low birth weight even after adjustment for maternal demographic and behavioral characteristics. Black race continues to be a significant predictor of spontaneous preterm birth, fetal growth restriction, and low birth weight even after adjustment for stress, substance use, and other demographic factors. (Am J Obstet Gynecol 1996;175:1286-92.)
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ISSN:0002-9378
1097-6868
DOI:10.1016/S0002-9378(96)70042-X