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

被引:476
作者
Copper, RL
Goldenberg, RL
Das, A
Elder, N
Swain, M
Norman, G
Ramsey, R
Cotroneo, P
Collins, BA
Johnson, F
Jones, P
Meier, A
Northern, A
Meis, PJ
MuellerHeubach, E
Frye, A
Mowad, AH
Miodovnik, M
Siddiqi, TA
Bain, R
Thom, E
Leuchtenburg, L
Fischer, M
Paul, RH
Kovacs, B
Rabello, Y
Caritis, S
Harger, JH
Cotroneo, M
Stallings, C
McNellis, D
Yaffee, S
Catz, C
Klebanoff, M
Iams, JD
Landon, MB
Thurnau, GR
Carey, JC
VanDorsten, JP
Neuman, RB
LeBoeuf, F
Sibai, B
Mercer, B
Fricke, J
Bottoms, SF
Dombrowski, MP
机构
[1] WAKE FOREST UNIV, BOWMAN GRAY SCH MED, WINSTON SALEM, NC USA
[2] UNIV CHICAGO, CHICAGO, IL 60637 USA
[3] UNIV CINCINNATI, CINCINNATI, OH 45221 USA
[4] GEORGE WASHINGTON UNIV, CTR BIOSTAT, WASHINGTON, DC 20052 USA
[5] UNIV SO CALIF, LOS ANGELES CTY MED CTR, LOS ANGELES, CA 90089 USA
[6] UNIV PITTSBURGH, PITTSBURGH, PA 15260 USA
[7] NICHHD, BETHESDA, MD 20892 USA
[8] OHIO STATE UNIV, COLUMBUS, OH 43210 USA
[9] UNIV OKLAHOMA, NORMAN, OK 73019 USA
[10] MED UNIV S CAROLINA, CHARLESTON, SC 29425 USA
[11] UNIV TENNESSEE, KNOXVILLE, TN 37996 USA
[12] WAYNE STATE UNIV, DETROIT, MI 48202 USA
关键词
psychosocial characteristics; stress; preterm birth; fetal growth restriction; low birth weight;
D O I
10.1016/S0002-9378(96)70042-X
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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.
引用
收藏
页码:1286 / 1292
页数:7
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