Psychosocial factors and preterm birth among African American and White women in central North Carolina

Am J Public Health. 2004 Aug;94(8):1358-65. doi: 10.2105/ajph.94.8.1358.


Objectives: We assessed associations between psychosocial factors and preterm birth, stratified by race in a prospective cohort study.

Methods: We surveyed 1898 women who used university and public health prenatal clinics regarding various psychosocial factors.

Results: African Americans were at higher risk of preterm birth if they used distancing from problems as a coping mechanism or reported racial discrimination. Whites were at higher risk if they had high counts of negative life events or were not living with a partner. The association of pregnancy-related anxiety with preterm birth weakened when medical comorbidities were taken into account. No association with preterm birth was found for depression, general social support, or church attendance.

Conclusions: Some associations between psychosocial variables and preterm birth differed by race.

Publication types

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

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Anxiety / complications
  • Anxiety / ethnology
  • Anxiety / psychology
  • Attitude to Health / ethnology
  • Birth Rate / ethnology*
  • Black or African American* / education
  • Black or African American* / ethnology
  • Black or African American* / psychology
  • Black or African American* / statistics & numerical data
  • Educational Status
  • Female
  • Health Behavior / ethnology
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Life Change Events
  • North Carolina / epidemiology
  • Obstetric Labor, Premature* / ethnology
  • Obstetric Labor, Premature* / psychology
  • Pregnancy
  • Pregnancy Outcome / ethnology
  • Pregnancy Outcome / psychology
  • Problem Solving
  • Prospective Studies
  • Risk Factors
  • Social Support
  • Stress, Psychological / complications
  • Stress, Psychological / ethnology
  • Stress, Psychological / psychology
  • Surveys and Questionnaires
  • White People* / education
  • White People* / ethnology
  • White People* / psychology
  • White People* / statistics & numerical data