The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation.
ABSTRACT The aim was to test a model of the influence of maternal prenatal psychosocial stress on birth outcomes after controlling for biomedical risk.
In a prospective study a sociodemographically homogeneous sample of 90 women was assessed during the third trimester with standard, reliable questionnaires that measured episodic and chronic stress, strain (response to stress), and pregnancy-related anxiety. Birth outcomes included infant birth weight, gestational age at birth, and intrapartum complications. Parity and biomedical (antepartum) risk was also coded. Bivariate and multivariate analyses were performed after controlling for the effects of biomedical risk factors.
Independent of biomedical risk, each unit increase of prenatal life event stress (from a possible sample range of 14.7 units) was associated with a 55.03 gm decrease in infant birth weight and with a significant increase in the likelihood of low birth weight (odds ratio 1.32), and each unit increase of prenatal pregnancy anxiety (from a possible sample range of 5 units) was associated with a 3-day decrease in gestational age at birth.
Independent of biomedical risk, maternal prenatal stress factors are significantly associated with infant birth weight and with gestational age at birth.
Full-textDOI: · Available from: Christine Dunkel Schetter, Apr 21, 2015
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ABSTRACT: Depression in pregnancy is a serious health issue; however, anxiety in pregnancy, with a reported higher prevalence, may also be a serious issue. Anxiety symptoms in pregnancy can relate to several anxiety types, such as general anxiety, anxiety disorders, and pregnancy-related anxiety (PrA), anxiety characterised by pregnancy specific fears and worries. Awareness of these distinctions however, is not always widespread. Both general anxiety and PrA are associated with maternal negative outcomes (e.g. increased nausea) however; PrA is more often associated with negative outcomes for the child (e.g. preterm birth). Furthermore, PrA is potentially a risk factor for postnatal depression with assessment of PrA potentially affording important intervention opportunities. Currently several different instruments are used for PrA however their psychometric properties are unclear. To our knowledge a review of current instruments and their psychometric properties is lacking, this paper aims to fill that gap. Studies, which assessed PrA, published between 1983 and 2013 in peer-reviewed journals, were identified. Sixty studies were identified after applying inclusion/exclusion criteria, and classified as: pregnancy-related anxiety specific, scales for other constructs, sub scales of another instrument and general anxiety scales. Each scale׳s strengths and limitations were discussed. Our findings may be limited by restricting our review to peer-reviewed journals. This was done however as we sought to identify scales with good psychometric properties. Currently no scales are available for pregnancy-related anxiety with sound theoretical and psychometric properties. Clinically the need for such a scale is highlighted by the potential intervention opportunities this may afford. Future research should be directed towards the development of such a scale. Copyright © 2015 Elsevier B.V. All rights reserved.Journal of Affective Disorders 05/2015; 176. DOI:10.1016/j.jad.2015.01.039 · 3.71 Impact Factor
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ABSTRACT: We examined the association between life events stressors during pregnancy and low birth weight (LBW) among African Americans and Whites, while systematically controlling for potential confounders including individual characteristics and city-level variations and clustering. We analyzed data from 4970 women with singleton births who participated in the 2007 and 2010 Los Angeles Mommy and Baby Surveys. Multilevel logistic regression was used to assess the association between emotional, financial, spousal and traumatic stressors and LBW among African Americans and Whites. Potential confounders included were: the city-level Economic Hardship Index, maternal demographics, pre-pregnancy conditions, insurance, behavioral risk factors and social support. African Americans were significantly more likely to experience any domain of stressors during their pregnancy, compared to Whites (p < 0.001). Only the association between financial stressors and LBW was significantly different between African Americans and Whites (p for interaction = 0.015). Experience of financial stressors during pregnancy was significantly associated with LBW among African Americans (adjusted odds ratio = 1.49; 95 % confidence interval = 1.01-2.22) but not Whites. Differential impact of financial stressors during pregnancy may contribute to racial disparities in LBW between African Americans and Whites. We showed that financial life event stressors, but not other domains of stressors, were more likely to impact LBW among African Americans than Whites. Initiatives aimed at mitigating the negative impacts of financial stress during pregnancy may contribute to reducing disparities in birth outcomes between African Americans and Whites.Maternal and Child Health Journal 02/2015; DOI:10.1007/s10995-015-1734-x · 2.24 Impact Factor
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ABSTRACT: Physiological disruptions resulting from an impoverished environment during the first years of life are of key importance for the health and biological status of individuals and populations. Studies of growth processes in archaeological populations point to the fact that the main causes of childhood mortality in the past are to be sought among extrinsic factors. Based on this assumption, one would expect random mortality of children, with the deceased individuals representing the entire subadult population. The purpose of this study is to explore whether differences in early childhood survival are reflected in differences in deciduous tooth enamel, which can provide an insight into the development of an individual during prenatal and perinatal ontogeny. Deciduous incisors were taken from 83 individuals aged 2.0-6.5 years from a medieval inhumation cemetery dated AD 1300-1600. Prenatal and postnatal enamel formation time, neonatal line width, and the number of accentuated lines were measured using an optical microscope. The significantly wider neonatal line and the higher frequency of accentuated lines in the enamel of the incisors of children who died at the age of 2-3 years suggest the occurrence of stronger or more frequent stress events in this group. These results indicate that in skeletal populations mortality was not exclusively determined by random external factors. Individuals predisposed by an unfavorable course of prenatal and perinatal growth were more likely to die in early childhood. Am J Phys Anthropol, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.American Journal of Physical Anthropology 02/2015; DOI:10.1002/ajpa.22731 · 2.51 Impact Factor