Top

Published in:

Open Access 01-12-2020 | Premature Birth | Research article

Periconceptional stressors and social support and risk for adverse birth outcomes

Authors: Kari A. Weber, Suzan L. Carmichael, Wei Yang, Sarah C. Tinker, Gary M. Shaw, National Birth Defects Prevention Study

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

Abstract

Background

The prevalence of preterm birth and low birth weight has been increasing slightly in recent years. A few studies have suggested that psychosocial stress during pregnancy may increase risk for these adverse birth outcomes. To extend those observations, we analyzed various major life event stressors separately and cumulatively as potential risk factors for preterm birth and low birth weight using granular categories of each outcome in a large, population-based study. Additionally, we assessed if greater social support buffered any effects.

Methods

Data were from a nested prevalence study of 4395 women in the National Birth Defects Prevention Study who delivered live-born non-malformed infants (controls) between 2006 and 2011. Participants completed a standardized, computer-assisted interview between 6 weeks and 24 months after delivery that included questions on stress and social support from 3 months before pregnancy to the 3rd month of pregnancy. Cumulative stress and support indices were also calculated. Preterm birth was divided into “early preterm” (< 32 weeks), “late preterm” (32–36 weeks) and “term.” Low birthweight was divided into “very low birth weight” (< 1500 g), “low birth weight” (1500–2499 g) and “normal birth weight” (≥2500 g). Relative risks and 95% confidence intervals (95% CI) were calculated using Poisson regression.

Results

For women reporting relationship difficulties, there was a suggestive risk of early preterm birth (RR: 1.9, 95%CI: 0.9–3.9) and very low birthweight (RR: 2.0, 95%CI: 0.9–4.4). For women reporting that they or someone close to them were victims of abuse, violence, or crime, there was an increased risk of low birthweight (RR: 1.8, 95%CI: 1.1–2.7) and late preterm birth (RR: 1.5, 95%CI: 1.0–2.2). There were no strong associations observed between social support questions and the various outcomes.

Conclusions

Our results add some support to prior evidence that certain stressors may be associated with increase selected adverse birth outcomes risk. We did not find strong evidence that social support buffered the observed risks in our study.

Available only for authorised users

Hamilton BE, Martin JA, Osterman MJK. Births: Preliminary data for 2015. National vital statistics reports; vol 65 no 3,. National Center for Health Statistics; 2016.

Dunkel SC. Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol. 2011;62:531–58.CrossRef

Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. Women and birth : journal of the Australian College of Midwives. 2015;28(3):179–93.CrossRef

Rondo PH, Ferreira RF, Nogueira F, Ribeiro MC, Lobert H, Artes R. Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr. 2003;57(2):266–72.PubMedCrossRef

Sable MR, Wilkinson DS. Impact of perceived stress, major life events and pregnancy attitudes on low birth weight. Fam Plan Perspect. 2000;32(6):288–94.CrossRef

Burns ER, Farr SL, Howards PP. Stressful life events experienced by women in the year before their infants' births--United States, 2000-2010. MMWR Morb Mortal Wkly Rep. 2015;64(9):247–51.PubMedPubMedCentral

Witt WP, Cheng ER, Wisk LE, Litzelman K, Chatterjee D, Mandell K, et al. Preterm birth in the United States: the impact of stressful life events prior to conception and maternal age. Am J Public Health. 2014;104(Suppl 1):S73–80.PubMedPubMedCentralCrossRef

Dole N, Savitz DA, Hertz-Picciotto I, Siega-Riz AM, McMahon MJ, Buekens P. Maternal stress and preterm birth. Am J Epidemiol. 2003;157(1):14–24.PubMedCrossRef

Zhu P, Tao F, Hao J, Sun Y, Jiang X. Prenatal life events stress: implications for preterm birth and infant birthweight. Am J Obstet Gynecol. 2010;203(1):34 e1–8.PubMedCrossRef

10.

Witt WP, Cheng ER, Wisk LE, Litzelman K, Chatterjee D, Mandell K, et al. Maternal stressful life events prior to conception and the impact on infant birth weight in the United States. Am J Public Health. 2014;104(Suppl 1):S81–9.PubMedPubMedCentralCrossRef

11.

Shah PS, Shah J. Maternal exposure to domestic violence and pregnancy and birth outcomes: a systematic review and meta-analyses. J Women’s Health (2002). 2010;19(11):2017–31.CrossRef

12.

Khashan AS, McNamee R, Abel KM, Mortensen PB, Kenny LC, Pedersen MG, et al. Rates of preterm birth following antenatal maternal exposure to severe life events: a population-based cohort study. Human Reprod (Oxford, England). 2009;24(2):429–37.CrossRef

13.

Shaw JG, Asch SM, Kimerling R, Frayne SM, Shaw KA, Phibbs CS. Posttraumatic stress disorder and risk of spontaneous preterm birth. Obstet Gynecol. 2014;124(6):1111–9.PubMedCrossRef

14.

McDonald SW, Kingston D, Bayrampour H, Dolan SM, Tough SC. Cumulative psychosocial stress, coping resources, and preterm birth. Arch Women's Mental HSealth. 2014;17(6):559–68.CrossRef

15.

Reefhuis J, Gilboa SM, Anderka M, Browne ML, Feldkamp ML, Hobbs CA, et al. The National Birth Defects Prevention Study: a review of the methods. Birth Defects Res Part A, Clin Mol Teratol. 2015;103(8):656–69.CrossRef

16.

Honein MA, Kirby RS, Meyer RE, Xing J, Skerrette NI, Yuskiv N, et al. The association between major birth defects and preterm birth. Matern Child Health J. 2009;13(2):164–75..PubMedCrossRef

17.

Carmichael SL, Shaw GM, Yang W, Abrams B, Lammer EJ, et al. Epidemiology (Cambridge, Mass). 2007;18(3):356–61.CrossRef

18.

Holmes TH, Rahe RH. The social readjustment rating scale. J Psychosom Res. 1967;11(2):213–8.PubMedCrossRef

19.

Sarason IG, Johnson JH, Siegel JM. Assessing the impact of life changes: development of the life experiences survey. J Consult Clin Psychol. 1978;46(5):932–46.PubMedCrossRef

20.

Newton RW, Hunt LP. Psychosocial stress in pregnancy and its relation to low birth weight. Br Med J (Clin Res Ed). 1984;288(6425):1191–4.CrossRef

21.

Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol. 1996;87(2):163–8.PubMedCrossRef

22.

Oken E, Kleinman KP, Rich-Edwards J, Gillman MW. A nearly continuous measure of birth weight for gestational age using a United States national reference. BMC Pediatr. 2003;3:6.PubMedPubMedCentralCrossRef

23.

Cogswell ME, Bitsko RH, Anderka M, Caton AR, Feldkamp ML, Hockett Sherlock SM, et al. Control selection and participation in an ongoing, population-based, case-control study of birth defects: the National Birth Defects Prevention Study. Am J Epidemiol. 2009;170(8):975–85.PubMedCrossRef

24.

Alwan S, Reefhuis J, Rasmussen SA, Friedman JM. Patterns of antidepressant medication use among pregnant women in a United States population. J Clin Pharmacol. 2011;51(2):264–70.PubMedCrossRef

25.

Reefhuis et al. Specific SSRIs and birth defects: Bayesian analysis to interpret new data in the context of previous reports. BMJ. 2015;350:h3190:1–8.

26.

Brunton PJ. Effects of maternal exposure to social stress during pregnancy: consequences for mother and offspring. Reproduction (Cambridge, England). 2013;146(5):R175–89.CrossRef

27.

Olson DM, Severson EM, Verstraeten BS, Ng JW, McCreary JK, Metz GA. Allostatic load and preterm birth. Int J Mol Sci. 2015;16(12):29856–74.PubMedPubMedCentralCrossRef

28.

Shapiro GD, Fraser WD, Frasch MG, Seguin JR. Psychosocial stress in pregnancy and preterm birth: associations and mechanisms. J Perinat Med. 2013;41(6):631–45.PubMedPubMedCentralCrossRef

29.

Wadhwa PD, Entringer S, Buss C, Lu MC. The contribution of maternal stress to preterm birth: issues and considerations. Clin Perinatol. 2011;38(3):351–84.PubMedPubMedCentralCrossRef

30.

Qu F, Wu Y, Zhu YH, Barry J, Ding T, Baio G, et al. The association between psychological stress and miscarriage: a systematic review and meta-analysis. Sci Rep. 2017;7(1):1731.PubMedPubMedCentralCrossRef

31.

Bruckner T, Catalano R. The sex ratio and age-specific male mortality: evidence for culling in utero. Am J Human Biol. 2007;19(6):763–73.CrossRef

32.

Bruckner TA, Catalano R. Selection in utero and population health: theory and typology of research. SSM - Population hHalth. 2018;5:101–13.CrossRef

33.

Newberger EH, Barkan SE, Lieberman ES, McCormick MC, Yllo K, Gary LT, et al. Abuse of pregnant women and adverse birth outcome. Current knowledge and implications for practice. Jama. 1992;267(17):2370–2.PubMedCrossRef

34.

Nylen KJ, O'Hara MW, Engeldinger J. Perceived social support interacts with prenatal depression to predict birth outcomes. J Behav Med. 2013;36(4):427–40.PubMedCrossRef

35.

Feldman PJ, Dunkel-Schetter C, Sandman CA, Wadhwa PD. Maternal social support predicts birth weight and fetal growth in human pregnancy. Psychosom Med. 2000;62(5):715–25.PubMedCrossRef

36.

Huybrechts KF, Sanghani RS, Avorn J, Urato AC. Preterm birth and antidepressant medication use during pregnancy: a systematic review and meta-analysis. PLoS One. 2014;9(3):e92778.PubMedPubMedCentralCrossRef

37.

Yonkers KA, Gilstad-Hayden K, Forray A, Lipkind HS. Association of Panic Disorder, Generalized Anxiety Disorder, and Benzodiazepine Treatment During Pregnancy With Risk of Adverse Birth Outcomes. JAMA psychiatry. 2017..

38.

Hoffman MC, Mazzoni SE, Wagner BD, Laudenslager ML, Ross RG. Measures of maternal stress and mood in relation to preterm birth. Obstet Gynecol. 2016;127(3):545–52.PubMedPubMedCentralCrossRef

39.

McLean DE, Hatfield-Timajchy K, Wingo PA, Floyd RL. Psychosocial measurement: implications for the study of preterm delivery in black women. Am J Prev Med. 1993;9(6 Suppl):39–81.PubMedCrossRef

Title: Periconceptional stressors and social support and risk for adverse birth outcomes
Authors: Kari A. Weber
Suzan L. Carmichael
Wei Yang
Sarah C. Tinker
Gary M. Shaw
National Birth Defects Prevention Study
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Premature Birth
Published in: BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-020-03182-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Periconceptional stressors and social support and risk for adverse birth outcomes

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2020

The timing of initiation of pharmacotherapy for women with gestational diabetes mellitus

Interventions for women who report domestic violence during and after pregnancy in low- and middle-income countries: a systematic literature review

Intraoperative coagulopathy during cesarean section as an unsuspected initial presentation of COVID-19: a case report

Spiral artery blood flow during pregnancy: a systematic review and meta-analysis

Magnitude and determinants of obstetric case fatality rate among women with the direct causes of maternal deaths in Ethiopia: a national cross sectional study

Predictors of home births among rural women in Ghana: analysis of data from the 2014 Ghana Demographic and Health Survey