title: Paternal support and preterm birth, and the moderation of effects of chronic stress: a study in Los Angeles county mothers.
abstract: Maternal psychosocial stress is an important risk factor for preterm birth, but support interventions have largely been unsuccessful. The objective of this study is to assess how support during pregnancy influences preterm birth risk and possibly ameliorates the effects of chronic stress, life event stress, or pregnancy anxiety in pregnant women. We examined 1,027 singleton preterm births and 1,282 full-term normal weight controls from a population-based retrospective case-control study of Los Angeles County, California women giving birth in 2003, a mostly Latina population (both US-born and immigrant). We used logistic regression to assess whether support from the baby's father during pregnancy influences birth outcomes and effects of chronic stress, pregnancy anxiety, and life event stress. Adjusted odds of preterm birth decreased with better support (OR 0.73 [95%CI 0.52, 1.01]). Chronic stress (OR 1.46 [95%CI 1.11, 1.92]), low confidence of a normal birth (OR 1.57 [95% CI 1.17, 2.12]), and fearing for the baby's health (OR 1.67 [95%CI 1.30, 2.14]) increased preterm birth risk, but life events showed no association. Our data also suggested that paternal support may modify the effect of chronic stress on the risk of preterm birth, such that among mothers lacking support, those with moderate-to-high stress were at increased odds of delivering preterm (OR 2.15 [95%CI 0.92, 5.03]), but women with greater support had no increased risk with moderate-to-high chronic stress (OR 1.13 [95%CI 0.94, 1.35]). Paternal support may moderate the effects of chronic stress on the risk of preterm delivery.
authors.affiliation: Department of Epidemiology, University of California, Los Angeles, 650 Charles E. Young Dr. South, CHS 71-254, Los Angeles, CA 90095-1772, USA. jokay@ucla.edu
authors.forename: Jo Kay C
authors.initials: JK
authors.lastname: Ghosh
authors.forename: Michelle H
authors.initials: MH
authors.lastname: Wilhelm
authors.forename: Christine
authors.initials: C
authors.lastname: Dunkel-Schetter
authors.forename: Christina A
authors.initials: CA
authors.lastname: Lombardi
authors.forename: Beate R
authors.initials: BR
authors.lastname: Ritz
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D005220:Fathers; D005260:Female; D005865:Gestational Age; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D012189:Retrospective Studies; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D055815:Young Adult