Maternal stressors and social support as risks for delivering babies with structural birth defects.
BACKGROUND
We examined the association of maternal stressful life events and social support with risks of birth defects using National Birth Defects Prevention Study data, a population-based case-control study.


METHODS
We examined seven stressful life events and three social support questions applicable to the periconceptional period, among mothers of 552 cases with neural tube defects (NTDs), 413 cleft palate (CP), 797 cleft lip ± cleft palate (CLP), 189 d-transposition of the great arteries (dTGA), 311 tetralogy of Fallot (TOF), and 2974 non-malformed controls. A stressful life events index equalled the sum of 'yes' responses to the seven questions. Social support questions were also summed to form an index. Data were analyzed using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusted for maternal race-ethnicity, age, education, body mass index, smoking, drinking, and intake of vitamin supplements.


RESULTS
Associations with the stress index tended to be higher with higher scores, but few 95% CIs excluded one. A four-point increase in the index was moderately associated with NTDs (OR 1.5, [95% CI 1.1, 2.0]) and CLP (OR 1.3, [95% CI 1.0, 1.7]). The social support index tended to be associated with reduced risk but most 95% CIs included one, with the exception of dTGA (OR for a score of 3 vs 0 was 0.5 [95% CI 0.3, 0.8]).


CONCLUSIONS
Maternal periconceptional stressful life events, social support, and the two factors in combination were at most modestly, if at all, associated with risks of the studied birth defects.
Department of Pediatrics, Stanford University, Stanford, CA.
Suzan L
SL
Carmichael
Chen
C
Ma
Sarah
S
Tinker
Sonia A
SA
Rasmussen
Gary M
GM
Shaw
D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D008016:Life Change Events; D008425:Maternal Behavior / Q000523:psychology*; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States
birth defects; social support; stress