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Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 10/2015

01-10-2015

Association Between Life Event Stressors and Low Birth Weight in African American and White Populations: Findings from the 2007 and 2010 Los Angeles Mommy and Baby (LAMB) Surveys

Authors: Yuan Zhao, Trace Kershaw, Adrienne S. Ettinger, Chandra Higgins, Michael C. Lu, Shin M. Chao

Published in: Maternal and Child Health Journal | Issue 10/2015

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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.
Literature
1.
Valero De Bernabé, J., Soriano, T., Albaladejo, R., Juarranz, M., Calle, M. E., Martínez, D., & Domínguez-Rojas, V. (2004). Risk factors for low birth weight: a review. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 116(1), 3–15.CrossRefPubMed
2.
Kleinman, J. C., & Kessel, S. S. (1987). Racial differences in low birth weight. Trends and risk factors. New England Journal of Medicine, 317(12), 749–753.CrossRefPubMed
3.
Lu, M. C., & Halfon, N. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7(1), 13–30.CrossRefPubMed
4.
Collins, J. W, Jr, & David, R. J. (2009). Racial disparity in low birth weight and infant mortality. Clinics in Perinatology, 36(1), 63–73.CrossRefPubMed
5.
6.
Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C., & Braveman, P. A. (2010). Socioeconomic disparities in adverse birth outcomes: A systematic review. American Journal of Preventive Medicine, 39(3), 263–272.CrossRefPubMed
7.
McIntosh, L. J., Roumayah, E. N., & Bottoms, S. F. (1995). Perinatal outcome of broken marriage in the inner city. International Journal of Gynecology and Obstetrics, 51(5), 368–375.
8.
Fink, J. C., Schawartz, S. M., Benedetti, T. J., & Stehman, C. O. (1998). Increased risk of adverse maternal and infant outcomes among women with renal disease. Paediatric and Perinatal Epidemiology, 12(3), 277–287.CrossRefPubMed
9.
Sharma, R., Synkewecz, C., Raggio, T., & Mattison, D. R. (1994). Intermediate variables as determinants of adverse pregnancy outcome in high risk inner city populations. Journal of the National Medical Association, 86(11), 857–860.PubMedCentralPubMed
10.
Windham, G. C., Hopkings, B., Fenster, L., & Swan, S. H. (2000). Prenatal active or passive tobacco smoke exposure and the risk of preterm delivery or low birth weight. Epidemiology, 11(4), 427–433.CrossRefPubMed
11.
Lazzaroni, F., Bonassi, S., Magnani, M., Calvi, A., Repetto, E., Serra, F., et al. (1993). Moderate maternal drinking and outcome of pregnancy. European Journal of Epidemiology, 9(6), 599–606.CrossRefPubMed
12.
Meng, G., Thompson, M. E., & Hall, G. B. (2013). Pathways of neighbourhood-level socio-economic determinants of adverse birth outcomes. International Journal of Health Geographics, 12, 32.PubMedCentralCrossRefPubMed
13.
Metcalfe, A., Lail, P., Ghali, W. A., & Sauve, R. S. (2011). The association between neighbourhoods and adverse birth outcomes: a systematic review and meta-analysis of multi-level studies. Paediatric and Perinatal Epidemiology, 25(3), 236–245.CrossRefPubMed
14.
15.
Stein, A., Campbell, E. A., Day, A., McPherson, K., & Cooper, P. J. (1987). Social adversity, low birthweight, and preterm delivery. British Medical Journal, 295(6593), 291–293.PubMedCentralCrossRefPubMed
16.
Mutale, T., Creed, F., Maresh, M., & Hunt, L. (1991). Life events and low birthweight—analysis by infants preterm and small for gestational age. British Journal of Obstetrics and Gynaecology, 98(2), 166–172.CrossRefPubMed
17.
Wadhwa, P. D., Sandman, C. A., Porto, M., Dunkel-Schetter, C., & Garite, T. J. (1993). The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. American Journal of Obstetrics and Gynecology, 169(4), 858–865.CrossRefPubMed
18.
Khashan, A. S., McNamee, R., Abel, K. M., Pedersen, M. G., Webb, R. T., Kenny, L. C., et al. (2008). Reduced infant birthweight consequent upon maternal exposure to severe life events. Psychosomatic Medicine, 70(6), 688–694.CrossRefPubMed
19.
Nkansah-Amankra, S., Luchok, K. J., Hussey, J. R., Watkins, K., & Liu, X. (2010). Effects of maternal stress on low birth weight and preterm birth outcomes across neighborhoods of South Carolina, 2000–2003. Maternal and Child Health Journal, 14(2), 215–226.CrossRefPubMed
20.
Brown, S. J., Yelland, J. S., Sutherland, G. A., Baghurst, P. A., & Robinson, J. S. (2011). Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort: challenges and opportunities in antenatal care. BMC Public Health, 11, 196.PubMedCentralCrossRefPubMed
21.
Torche, F. (2011). The effect of maternal stress on birth outcomes: Exploiting a natural experiment. Demography, 48(4), 1473–1491.CrossRefPubMed
22.
Wainstock, T., Anteby, E., Glasser, S., Shoham-Vardi, I., & Lerner-Geva, L. (2013). The association between prenatal maternal objective stress, perceived stress, preterm birth and low birthweight. The Journal of Maternal-Fetal Medicine, 26(10), 973–977.CrossRef
23.
Wainstock, T., Anteby, E. Y., Glasser, S., Lerner-Geva, L., & Shoham-Vardi, I. (2014). Exposure to life-threatening stressful situations and the risk of preterm birth and low birth weight. International Journal of Gynaecology and Obstetrics, 125(1), 28–32.CrossRefPubMed
24.
Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11(2), 213–218.CrossRefPubMed
25.
Rinaudo, P. F., & Lamb, J. (2008). Fetal origins of perinatal morbidity and/or adult disease. Seminars in Reproductive Medicine, 26(5), 436–445.CrossRefPubMed
26.
Collins, J. W, Jr, Simon, D. M., Jackson, T. A., & Drolet, A. (2006). Advancing maternal age and infant birth weight among urban African Americans: the effect of neighborhood poverty. Ethnicity and Disease, 16(1), 180–186.PubMed
27.
Buka, S. L., Brennan, R. T., Rich-Edwards, J. W., Raudenbush, S. W., & Earls, F. (2003). Neighborhood support and the birth weight of urban infants. American Journal of Epidemiology, 157, 1–8.CrossRefPubMed
28.
Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: evidence and needed research. Journal of Behavioral Medicine, 32(1), 20–47.PubMedCentralCrossRefPubMed
29.
Rosenthal, L., & Lobel, M. (2011). Explaining racial disparities in adverse birth outcomes: Unique sources of stress for Black American women. Social Science and Medicine, 72(6), 977–983.CrossRefPubMed
30.
Geronimus, A. T. (1996). Black/white differences in the relationship of maternal age to birthweight: A population-based test of the weathering hypothesis. Social Science and Medicine, 42(4), 589–597.CrossRefPubMed
31.
Dawson, D. A., Grant, B. F., & Ruan, W. J. (2005). The association between stress and drinking: modifying effects of gender and vulnerability. Alcohol and Alcoholism, 40(5), 453–460.CrossRefPubMed
32.
Jacobsen, L. K., Southwick, S. M., & Kosten, T. R. (2001). Substance use disorders in patients with posttraumatic stress disorder: A review of the literature. American Journal of Psychiatry, 158(8), 1184–1190.CrossRefPubMed
33.
Brawarsky, P., Stotland, N. E., Jackson, R. A., Fuentes-Afflick, E., Escobar, G. J., Rubashkin, N., & Haas, J. S. (2005). Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain. International Journal of Gynaecology and Obstetrics, 91(2), 125–131.CrossRefPubMed
34.
Gilbert, B. C., Shulman, H. B., Fischer, L. A., & Rogers, M. M. (1999). The pregnancy risk assessment monitoring system (PRAMS): Methods and 1996 response rates from 11 states. Maternal and Child Health Journal, 3, 199–209.CrossRefPubMed
35.
Institute of Medicine (US). (2011). Committee on Leading Health Indicators for Healthy People 2020. Leading Health Indicators for Healthy People 2020: Letter Report. Washington (DC): National Academies Press (US).
36.
Nathan, R. P., & Adams, C. F, Jr. (1976). Understanding central city hardship. Political Science Quarterly, 91(1), 47–62.CrossRef
37.
Nathan, R. P., & Adams, C. F, Jr. (1989). Four perspectives on urban hardship. Political Science Quarterly, 104, 482–508.
38.
Montiel, L. M., Nathan, R. P., & Wright, D. J. (2004). An update on urban hardship. Albany NY: The Nelson A. Rockefeller Institute of Government.
39.
Cochrane, R., & Robertson, A. (1973). The life events inventory: A measure of the relative severity of psycho-social stressors. Journal of Psychosomatic Research, 17(2), 135–140.CrossRefPubMed
40.
Newton, R. W., Webster, P. A., Binu, P. S., Maskrey, N., & Phillips, A. B. (1979). Psychosocial stress in pregnancy and its relation to the onset of premature labour. British Medical Journal, 2(6187), 411–413.PubMedCentralCrossRefPubMed
41.
42.
Institute of Medicine and National Research Council. (2009). Weight gain during pregnancy: Reexamining the guidelines. Washington (DC): The National Academies Press.
43.
Greenland, S., & Mickey, R. M. (1989). The impact of confounder selection criteria on effect estimation. American Journal of Epidemiology, 129(1), 125–137.PubMed
44.
Tofighi, D., & MacKinnon, D. P. (2011). RMediation: An R package for mediation analysis confidence intervals. Behavior Research Methods, 43, 692–700.PubMedCentralCrossRefPubMed
45.
Lockwood, C. J. (1999). Stress-associated preterm delivery: The role of corticotropin-releasing hormone. American Journal of Obstetrics and Gynecology, 180(1 Pt 3), S264–S266.CrossRefPubMed
46.
Omer, H. (1986). Possible psychophysiologic mechanisms in premature labor. Psychosomatics, 27, 580–584.CrossRefPubMed
47.
Oklahoma State Department of Health. (2009). Stressors, social support and pregnancy outcomes among African American and White mothers. PRAMSgram: Oklahoma pregnancy risk assessment monitoring. System, 13, 2.
Metadata
Title
Association Between Life Event Stressors and Low Birth Weight in African American and White Populations: Findings from the 2007 and 2010 Los Angeles Mommy and Baby (LAMB) Surveys
Authors
Yuan Zhao
Trace Kershaw
Adrienne S. Ettinger
Chandra Higgins
Michael C. Lu
Shin M. Chao
Publication date
01-10-2015
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 10/2015
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-015-1734-x

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