The relationships among psychosocial profile, maternal size, and smoking in predicting fetal growth retardation

Obstet Gynecol. 1992 Aug;80(2):262-7.


Objective: We explored the relationships among measures of psychosocial well-being, maternal size, and smoking in predicting infant size at birth.

Methods: Participants in this population-based cohort study were drawn from public health prenatal clinics in Jefferson County, Alabama during 1985-1988. Para 1 and 2 women were screened for 11 risk factors for low birth weight, including small stature, a previous low birth weight infant, and smoking.

Results: Poor scores on five of six psychosocial scales, as well as on a combined profile, were associated with a significantly higher relative risk of fetal growth retardation (FGR) only in thinner women, defined as having a body mass index less than the median (relative risk [RR] 2.11, 95% confidence interval [CI] 1.47, 3.04). A significant association between the psychosocial profile and birth weight was demonstrated for thin women in a multivariate analysis adjusting for gestational age, race, infant sex, and smoking (P = .0003). The relationship remained significant when hypertension, alcohol and drug use, and weight gain were added to the model (P = .003). In women with a body mass index above the median, a poor psychosocial profile showed little association with FGR (RR 1.20, 95% CI 0.73, 1.98) and did not have a significant association with birth weight. A poor profile had a greater association with FGR in non-smokers (RR 2.04, 95% CI 1.29, 3.22) than in smokers (RR 1.4, 95% CI 0.95, 2.06).

Conclusions: Greater pre-pregnancy weight for height appears to protect against the adverse effects of a poor psychosocial profile in a population of poor, primarily black women. In thinner women, both smoking and a poor psychosocial profile were associated with a substantially increased rate of FGR, indicating a subgroup of women who may receive greater benefits from intervention programs.

Publication types

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

MeSH terms

  • Body Mass Index*
  • Female
  • Fetal Growth Retardation / etiology*
  • Humans
  • Infant, Newborn
  • Personality
  • Pregnancy / psychology*
  • Prospective Studies
  • Risk Factors
  • Smoking / adverse effects*
  • Social Support
  • Stress, Psychological