title: The Relationships of Health Behaviour and Psychological Characteristics with Spontaneous Preterm Birth in Nulliparous Women.
abstract: Objectives Preterm birth is the leading pregnancy outcome associated with perinatal morbidity and mortality and remains difficult to prevent. There is evidence that some modifiable maternal health characteristics may influence the risk of preterm birth. Our aim was to investigate the relationships of self-reported maternal health behaviour and psychological characteristics in nulliparous women with spontaneous preterm birth in prenatal primary care. Methods The data of our prospective study was obtained from the nationwide DELIVER multicentre cohort study (September 2009-March 2011), which was designed to examine perinatal primary care in the Netherlands. In our study, consisting of 2768 nulliparous women, we estimated the relationships of various self-reported health behaviours (smoking, alcohol consumption, folic acid supplementation, daily fruit, daily fresh vegetables, daily hot meal and daily breakfast consumption) and psychological characteristics (anxious/depressed mood and health control beliefs) with spontaneous preterm birth as a dichotomous outcome. Due to the clustering of clients within midwife practices, Generalized Estimating Equations was used for these analyses. Results Low health control beliefs was the sole characteristic significantly associated with spontaneous preterm birth (odds ratio 2.26; 95 % confidence interval 1.51, 3.39) after being adjusted for socio-demographics, anthropometrics and the remaining health behaviour and psychological characteristics. The other characteristics were not significantly associated with spontaneous preterm birth. Conclusions for Practice Maternal low health control beliefs need to be explored further as a possible marker for women at risk for preterm birth, and as a potentially modifiable characteristic to be used in interventions which are designed to reduce the risk of spontaneous preterm birth.
authors: Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG) and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. r.baron@vumc.nl.
authors: Ruth
authors: R
authors: Baron
authors: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors: Saskia J
authors: SJ
authors: Te Velde
authors: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.|Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
authors: Martijn W
authors: MW
authors: Heymans
authors: Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG) and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors: Trudy
authors: T
authors: Klomp
authors: Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG) and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.|Department of Obstetrics and Gynecology, McMaster University, 1280 Main Street West, MDCL 2210, Hamilton, ON, L8S 4K1, Canada.
authors: Eileen K
authors: EK
authors: Hutton
authors: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors: Johannes
authors: J
authors: Brug
mesh_terms: D000328:Adult; D001294:Attitude to Health; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008423:Maternal Age; D000068097:Maternal Health / Q000706:statistics & numerical data*; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data*; D009426:Netherlands; D011247:Pregnancy; D047928:Premature Birth / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors
keywords: Health control beliefs; Maternal health behaviours; Preterm birth; Primary care