Pregnancy-specific stress, preterm birth, and gestational age among high-risk young women.
OBJECTIVE
There is evidence that pregnancy-specific stress is associated with preterm birth. The purpose of this study is to examine the association between change in pregnancy-specific stress over the course of pregnancy and birth outcomes (i.e., preterm birth and gestational age) in an understudied but vulnerable group using a theoretically derived model.


METHODS
Multivariate linear and logistic regression techniques were used to examine the association between pregnancy-specific stress (measured in second and third trimester) and length of gestation (i.e., preterm birth and gestational age) among a sample of 920 Black and/or Latina adolescent and young women.


RESULTS
Second trimester pregnancy-specific stress was not associated with preterm birth or gestational age. Third trimester pregnancy-specific stress was associated with preterm birth but not with gestational age. Change in pregnancy-specific stress between second and third trimester was significantly associated with increased likelihood of preterm delivery and shortened gestational age, even after controlling for important biological, behavioral, psychological, interpersonal, and sociocultural risk factors.


CONCLUSIONS
Findings emphasize the importance of measuring pregnancy-specific stress across pregnancy, as the longitudinal change from second to third trimester was significantly associated with length of gestation measured both as a dichotomous variable (preterm birth) and a continuous variable (gestational age). Furthermore, this is the first study to observe the association of pregnancy-specific stress with length of gestation in this understudied population-unique in age, race, and ethnicity.
School of Public Health.
Heather J
HJ
Cole-Lewis
School of Public Health.
Trace S
TS
Kershaw
Center for Interdisciplinary Research on AIDS, Yale University.
Valerie A
VA
Earnshaw
School of Medicine, Yale University.
Kimberly Ann
KA
Yonkers
School of Public Health.
Haiqun
H
Lin
School of Public Health.
Jeannette R
JR
Ickovics
D000293:Adolescent; D001741:Black or African American; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D005845:Georgia / Q000453:epidemiology; D005865:Gestational Age; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology / Q000523:psychology*; D011256:Pregnancy Outcome / Q000208:ethnology / Q000523:psychology*; D047928:Premature Birth / Q000208:ethnology / Q000209:etiology* / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D013315:Stress, Psychological / Q000150:complications* / Q000208:ethnology / Q000523:psychology; D055815:Young Adult