title: Maternal stress and preterm birth.
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.
authors.affiliation: Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, 27599-8120, USA. nancy_dole@unc.edu
authors.forename: N
authors.initials: N
authors.lastname: Dole
authors.forename: D A
authors.initials: DA
authors.lastname: Savitz
authors.forename: I
authors.initials: I
authors.lastname: Hertz-Picciotto
authors.forename: A M
authors.initials: AM
authors.lastname: Siega-Riz
authors.forename: M J
authors.initials: MJ
authors.lastname: McMahon
authors.forename: P
authors.initials: P
authors.lastname: Buekens
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data; D001007:Anxiety / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D015897:Comorbidity; D005260:Female; D006801:Humans; D008016:Life Change Events; D008019:Life Style; D009035:Mothers / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D011287:Prejudice; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D044465:White People / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data