The preterm prediction study

Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation

R. L. Copper, R. L. Goldenberg, A. Das, N. Elder, M. Swain, G. Norman, Risa Ramsey, P. Cotroneo, B. A. Collins, F. Johnson, P. Jones, A. Meier, J. M. Roberts, J. C. Hauth, A. Northen, P. J. Meis, E. Mueller-Heubach, A. Frye, A. H. Mowad

Research output: Contribution to journalArticle

481 Citations (Scopus)

Abstract

OBJECTIVE: Our purpose was to determine whether various measures of poor psychosocial status in pregnancy are associated with spontaneous preterm birth, fetal growth restriction, or low birth weight. STUDY DESIGN: Anxiety, stress, self-esteem, mastery, and depression were assessed at 25 to 29 weeks in 2593 gravid women by use of a 28-item Likert scale. Scores for each psychosocial subscale were determined, and an overall psychosocial score was calculated. Scores were divided into quartiles, and the lowest quartile scores were used to define poor psychosocial status. The percent spontaneous preterm birth, low birth weight, and fetal growth restriction in women with low and high psychosocial scores were compared. Logistic regression analyses provided the odds ratios and 95% confidence intervals. RESULTS: Analyses revealed that stress was significantly associated with spontaneous preterm birth and with low birth weight with odds ratios of 1.16, p = 0.003, and 1.08, p = 0.02, respectively, for each point on the scale. A low score on the combined scale or on any subscale other than stress did not predict spontaneous preterm birth, fetal growth restriction, or low birth weight. After multivariate adjustment was performed for psychosocial status, substance use, and demographic traits, black race was the only variable significantly associated with spontaneous preterm birth, fetal growth restriction, and low birth weight; stress and low education were associated with spontaneous preterm birth and low birth weight. CONCLUSION: Stress was associated with spontaneous preterm birth and low birth weight even after adjustment for maternal demographic and behavioral characteristics. Black race continues to be a significant predictor of spontaneous preterm birth, fetal growth restriction, and low birth weight even after adjustment for stress, substance use, and other demographic factors.

Original languageEnglish (US)
Pages (from-to)1286-1292
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume175
Issue number5
DOIs
StatePublished - Jan 1 1996

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Premature Birth
Low Birth Weight Infant
Mothers
Fetal Development
Pregnancy
Demography
Odds Ratio
Social Adjustment
Self Concept
Anxiety
Logistic Models
Regression Analysis
Confidence Intervals
Depression
Education

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

The preterm prediction study : Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation. / Copper, R. L.; Goldenberg, R. L.; Das, A.; Elder, N.; Swain, M.; Norman, G.; Ramsey, Risa; Cotroneo, P.; Collins, B. A.; Johnson, F.; Jones, P.; Meier, A.; Roberts, J. M.; Hauth, J. C.; Northen, A.; Meis, P. J.; Mueller-Heubach, E.; Frye, A.; Mowad, A. H.

In: American Journal of Obstetrics and Gynecology, Vol. 175, No. 5, 01.01.1996, p. 1286-1292.

Research output: Contribution to journalArticle

Copper, RL, Goldenberg, RL, Das, A, Elder, N, Swain, M, Norman, G, Ramsey, R, Cotroneo, P, Collins, BA, Johnson, F, Jones, P, Meier, A, Roberts, JM, Hauth, JC, Northen, A, Meis, PJ, Mueller-Heubach, E, Frye, A & Mowad, AH 1996, 'The preterm prediction study: Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation', American Journal of Obstetrics and Gynecology, vol. 175, no. 5, pp. 1286-1292. https://doi.org/10.1016/S0002-9378(96)70042-X
Copper, R. L. ; Goldenberg, R. L. ; Das, A. ; Elder, N. ; Swain, M. ; Norman, G. ; Ramsey, Risa ; Cotroneo, P. ; Collins, B. A. ; Johnson, F. ; Jones, P. ; Meier, A. ; Roberts, J. M. ; Hauth, J. C. ; Northen, A. ; Meis, P. J. ; Mueller-Heubach, E. ; Frye, A. ; Mowad, A. H. / The preterm prediction study : Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation. In: American Journal of Obstetrics and Gynecology. 1996 ; Vol. 175, No. 5. pp. 1286-1292.
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abstract = "OBJECTIVE: Our purpose was to determine whether various measures of poor psychosocial status in pregnancy are associated with spontaneous preterm birth, fetal growth restriction, or low birth weight. STUDY DESIGN: Anxiety, stress, self-esteem, mastery, and depression were assessed at 25 to 29 weeks in 2593 gravid women by use of a 28-item Likert scale. Scores for each psychosocial subscale were determined, and an overall psychosocial score was calculated. Scores were divided into quartiles, and the lowest quartile scores were used to define poor psychosocial status. The percent spontaneous preterm birth, low birth weight, and fetal growth restriction in women with low and high psychosocial scores were compared. Logistic regression analyses provided the odds ratios and 95{\%} confidence intervals. RESULTS: Analyses revealed that stress was significantly associated with spontaneous preterm birth and with low birth weight with odds ratios of 1.16, p = 0.003, and 1.08, p = 0.02, respectively, for each point on the scale. A low score on the combined scale or on any subscale other than stress did not predict spontaneous preterm birth, fetal growth restriction, or low birth weight. After multivariate adjustment was performed for psychosocial status, substance use, and demographic traits, black race was the only variable significantly associated with spontaneous preterm birth, fetal growth restriction, and low birth weight; stress and low education were associated with spontaneous preterm birth and low birth weight. CONCLUSION: Stress was associated with spontaneous preterm birth and low birth weight even after adjustment for maternal demographic and behavioral characteristics. Black race continues to be a significant predictor of spontaneous preterm birth, fetal growth restriction, and low birth weight even after adjustment for stress, substance use, and other demographic factors.",
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AU - Das, A.

AU - Elder, N.

AU - Swain, M.

AU - Norman, G.

AU - Ramsey, Risa

AU - Cotroneo, P.

AU - Collins, B. A.

AU - Johnson, F.

AU - Jones, P.

AU - Meier, A.

AU - Roberts, J. M.

AU - Hauth, J. C.

AU - Northen, A.

AU - Meis, P. J.

AU - Mueller-Heubach, E.

AU - Frye, A.

AU - Mowad, A. H.

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N2 - OBJECTIVE: Our purpose was to determine whether various measures of poor psychosocial status in pregnancy are associated with spontaneous preterm birth, fetal growth restriction, or low birth weight. STUDY DESIGN: Anxiety, stress, self-esteem, mastery, and depression were assessed at 25 to 29 weeks in 2593 gravid women by use of a 28-item Likert scale. Scores for each psychosocial subscale were determined, and an overall psychosocial score was calculated. Scores were divided into quartiles, and the lowest quartile scores were used to define poor psychosocial status. The percent spontaneous preterm birth, low birth weight, and fetal growth restriction in women with low and high psychosocial scores were compared. Logistic regression analyses provided the odds ratios and 95% confidence intervals. RESULTS: Analyses revealed that stress was significantly associated with spontaneous preterm birth and with low birth weight with odds ratios of 1.16, p = 0.003, and 1.08, p = 0.02, respectively, for each point on the scale. A low score on the combined scale or on any subscale other than stress did not predict spontaneous preterm birth, fetal growth restriction, or low birth weight. After multivariate adjustment was performed for psychosocial status, substance use, and demographic traits, black race was the only variable significantly associated with spontaneous preterm birth, fetal growth restriction, and low birth weight; stress and low education were associated with spontaneous preterm birth and low birth weight. CONCLUSION: Stress was associated with spontaneous preterm birth and low birth weight even after adjustment for maternal demographic and behavioral characteristics. Black race continues to be a significant predictor of spontaneous preterm birth, fetal growth restriction, and low birth weight even after adjustment for stress, substance use, and other demographic factors.

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