Psychosocial factors in pregnancy and birthweight: Path analysis.
OBJECTIVE
Birthweight is known to be affected by several factors. In the present study a relationship model of psychological and economic determinants of birthweight was designed and tested.


METHODS
This prospective study involved 400 pregnant women in four districts of Tehran, Iran. The subjects were selected through a multistage sampling method. Seven questionnaires (socioeconomic status; Holmes and Rahe Stress Scale; Perceived Stress Scale; 21-item Depression, Anxiety, and Stress Scale [DASS-21]; perceived social support; pregnancy-related anxiety scale; and domestic violence questionnaire) were used to assess participant psychosocial and economic conditions. In order to collect post-partum information about the mother and the infant, the women were followed up until delivery. Data were analyzed using SPSS-16 and Lisrel-8.8.


RESULTS
Based on the obtained path diagram, the greatest adverse effects on birthweight were exerted directly by DASS-21 score (B = -0.14) and indirectly by stressful life events (B = -0.037). Among variables that affected birthweight in both paths, socioeconomic status and perceived stress had the strongest overall effects on birthweight (B = 0.203 and -0.1024, respectively).


CONCLUSIONS
According to the path analysis model, psychosocial and economic factors can directly/indirectly affect birthweight.
Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran.
Mahrokh
M
Dolatian
Faculty of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran.
Zohreh
Z
Mahmoodi
Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran.
Hamid
H
Alavi-Majd
Faculty of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
Farnoosh
F
Moafi
Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran.
Maryam
M
Ghorbani
Department of Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR, Iran.|Department of Psychiatric, University of Social Welfare and Rehabilitation Sciences, Tehran, IR, Iran.
Arash
A
Mirabzadeh
D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D001724:Birth Weight; D003863:Depression / Q000453:epidemiology; D017579:Domestic Violence / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008960:Models, Psychological; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011584:Psychology; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology; D055815:Young Adult
birthweight; path analysis; psychosocial factor