Maternal history of adoption or foster care placement in childhood: a risk factor for preterm birth.
OBJECTIVE
The objective of the study was to assess the impact of maternal history of adoption or foster care placement in childhood on the risk for preterm birth (PTB), controlling for other known risk factors for PTB.


METHODS
Participants were 302 pregnant women from a low-income, diverse sample drawn from 2 intensive prospective studies of maternal mood and behavior and fetal and infant development. Gestational age was determined by best obstetric estimate. Maternal history of adoption or foster care placement prior to age 18 years was determined by maternal report. Other maternal characteristics, including maternal medical conditions, psychosocial characteristics, and health behaviors, were measured during the second and third trimesters of pregnancy.


RESULTS
The odds of delivering preterm (gestational age <37 weeks) were approximately 4 times greater among women with a history of childhood adoption or foster care placement compared with women who were never placed out of the home during childhood. This association remained significant after adjusting for other known risk factors for PTB including maternal medical conditions, psychosocial characteristics, and negative health behaviors in pregnancy.


CONCLUSIONS
Findings suggest that a history of adoption/foster care placement is an important risk factor for PTB and may be comparable with other established risk factors for PTB including prior history of PTB, body mass index, African-American race, and advanced maternal age. More studies are needed to understand why women with placement histories may be at increased risk to deliver preterm.
Centers for Behavioral and Preventive Medicine, Alpert Medical School of Brown University, and The Miriam Hospital, Providence, RI. Electronic address: mbublitz@lifespan.org.
Margaret H
MH
Bublitz
Centers for Behavioral and Preventive Medicine, Alpert Medical School of Brown University, and The Miriam Hospital, Providence, RI.
Daniel
D
Rodriguez
Centers for Behavioral and Preventive Medicine, Alpert Medical School of Brown University, and The Miriam Hospital, Providence, RI.
Asi
A
Polly Gobin
Centers for Behavioral and Preventive Medicine, Alpert Medical School of Brown University, and The Miriam Hospital, Providence, RI.
Marissa
M
Waldemore
Department of Family Medicine, Alpert Medical School of Brown University, Memorial Hospital of Rhode Island, Pawtucket, RI.
Susanna
S
Magee
Centers for Behavioral and Preventive Medicine, Alpert Medical School of Brown University, and The Miriam Hospital, Providence, RI.
Laura R
LR
Stroud
D000293:Adolescent; D000300:Adoption / Q000523:psychology; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005581:Foster Home Care / Q000523:psychology; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology* / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological; D055815:Young Adult
adoption; early life stress; foster care; pregnancy; preterm birth