title: Infant birthweight in the US: the role of preconception stressful life events and substance use.
abstract: The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women's alcohol and tobacco use before and during pregnancy, and infant birthweight. Data were from the Early Childhood Longitudinal Study-Birth Cohort (n = 9,350). Data were collected in 2001. Exposure to PSLEs was defined by indications of death of a parent, spouse, or previous live born child; divorce or marital separation; or fertility problems prior to conception. Survey data determined alcohol and tobacco usage during the 3 months prior to and in the final 3 months of pregnancy. We used staged multivariable logistic regression to estimate the effects of women's substance use and PSLEs on the risk of having a very low (<1,500 g, VLBW) or low (1,500-2,499 g, LBW) birthweight infant, adjusting for confounders. Women who experienced any PSLE were more likely to give birth to VLBW infants (adjusted odds ratio [AOR] = 1.35; 95 % confidence interval [CI] = 1.10-1.66) than women who did not experience any PSLE. Compared to women who never smoked, women who smoked prior to conception (AOR = 1.31; 95 % CI = 1.04-1.66) or during their last trimester (AOR = 1.98; 95 % CI = 1.56-2.52) were more likely to give birth to LBW infants. PSLEs and women's tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby. Interventions to improve birth outcomes may need to address women's health and health behaviors in the preconception period.
authors.affiliation: Center for Maternal and Child Health Research, Truven Health Analytics, Inc, 4819 Emperor Boulevard, Suite 125, Durham, NC, 27703, USA. whitney.witt@truvenhealth.com.
authors.forename: Whitney P
authors.initials: WP
authors.lastname: Witt
authors.affiliation: CNA, Arlington, VA, USA.
authors.forename: Kara C
authors.initials: KC
authors.lastname: Mandell
authors.affiliation: Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, MA, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Wisk
authors.affiliation: Department of Pediatrics, Section of Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Erika R
authors.initials: ER
authors.lastname: Cheng
authors.affiliation: Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota-Twin Cities, Minneapolis, MN, USA.
authors.forename: Debanjana
authors.initials: D
authors.lastname: Chatterjee
authors.affiliation: Ferris State University's College of Health Professions, Big Rapids, MI, USA.
authors.forename: Fathima
authors.initials: F
authors.lastname: Wakeel
authors.affiliation: Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
authors.forename: Hyojun
authors.initials: H
authors.lastname: Park
authors.affiliation: Department of Psychology, University of Wisconsin, Madison, WI, USA.
authors.forename: Dakota
authors.initials: D
authors.lastname: Zarak
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008016:Life Change Events; D008297:Male; D016742:Preconception Care; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D037841:Pregnant People / Q000523:psychology*; D011297:Prenatal Exposure Delayed Effects; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: Alcohol and tobacco use prior to and during pregnancy; Infant birth weight; Lifecourse; Preconception stressful life events; Substance use