title: Maternal psychosocial risks predict preterm birth in a group of women from Appalachia.
abstract: OBJECTIVE
  To identify and evaluate which psychosocial criteria are associated with preterm birth in a midwifery model of risk in pregnancy.
  
  
  METHODS
  A quantitative study with a prospective correlational research design.
  
  
  METHODS
  Women attending three prenatal clinics in East Tennessee.
  
  
  METHODS
  120 pregnant women between 16 and 28 weeks gestation. The majority of the clinics' clients were from rural Appalachia.
  
  
  RESULTS
  Multiple logistic regression statistical analysis revealed that women with symptoms of depression, lower levels of self-esteem, or a negative perception of pregnancy had significantly higher odds of delivering a preterm baby.
  
  
  CONCLUSIONS
  These findings suggest the importance of screening for psychosocial risk factors in pregnancy. Interventions to address these psychosocial risks could improve maternal psychosocial health, maintain continuity of midwifery care, and reduce the incidence of preterm birth.
authors.affiliation: Purdue University School of Nursing, West Lafayette, IN 47907-1337, USA. ejesse@purdue.edu
authors.forename: D Elizabeth
authors.initials: DE
authors.lastname: Jesse
authors.forename: William
authors.initials: W
authors.lastname: Seaver
authors.forename: Debra C
authors.initials: DC
authors.lastname: Wallace
mesh_terms: D000293:Adolescent; D000328:Adult; D001061:Appalachian Region; D003863:Depression; D005260:Female; D006801:Humans; D008425:Maternal Behavior / Q000523:psychology*; D008880:Midwifery / Q000379:methods* / Q000592:standards; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D007752:Obstetric Labor, Premature / Q000451:nursing* / Q000517:prevention & control* / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000523:psychology*; D011295:Prenatal Care / Q000379:methods*; D012307:Risk Factors; D012649:Self Concept; D012944:Social Support; D012959:Socioeconomic Factors; D013714:Tennessee