Maternal stress and preterm birth

Am J Epidemiol. 2003 Jan 1;157(1):14-24. doi: 10.1093/aje/kwf176.

Abstract

This study examined a comprehensive array of psychosocial factors, including life events, social support, depression, pregnancy-related anxiety, perceived discrimination, and neighborhood safety in relation to preterm birth (<37 weeks) in a prospective cohort study of 1,962 pregnant women in central North Carolina between 1996 and 2000, in which 12% delivered preterm. There was an increased risk of preterm birth among women with high counts of pregnancy-related anxiety (risk ratio (RR) = 2.1, 95% confidence interval (CI): 1.5, 3.0), with life events to which the respondent assigned a negative impact weight (RR = 1.8, 95% CI: 1.2, 2.7), and with a perception of racial discrimination (RR = 1.4, 95% CI: 1.0, 2.0). Different levels of social support or depression were not associated with preterm birth. Preterm birth initiated by labor or ruptured membranes was associated with pregnancy-related anxiety among women assigning a high level of negative impact weights (RR = 3.0, 95% CI: 1.7, 5.3). The association between high levels of pregnancy-related anxiety and preterm birth was reduced when restricted to women without medical comorbidities, but the association was not eliminated. The prospective collection of multiple psychosocial measures on a large population of women indicates that a subset of these factors is associated with preterm birth.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / education
  • African Americans / psychology
  • African Americans / statistics & numerical data
  • Anxiety / complications*
  • Anxiety / epidemiology
  • Anxiety / prevention & control
  • Comorbidity
  • Female
  • Humans
  • Life Change Events
  • Life Style
  • Mothers / education
  • Mothers / psychology
  • Mothers / statistics & numerical data
  • Multivariate Analysis
  • North Carolina / epidemiology
  • Obstetric Labor, Premature / etiology*
  • Pregnancy
  • Pregnancy Complications* / prevention & control
  • Prejudice
  • Prospective Studies
  • Residence Characteristics
  • Risk Factors
  • Social Support
  • Stress, Psychological / complications*
  • Stress, Psychological / epidemiology
  • Stress, Psychological / prevention & control
  • Surveys and Questionnaires
  • Whites / education
  • Whites / psychology
  • Whites / statistics & numerical data