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J Womens Health (Larchmt). 2018 May;27(5):699-708. doi: 10.1089/jwh.2016.6118. Epub 2017 Dec 7.

Prenatal Perceived Stress and Adverse Birth Outcomes Among Puerto Rican Women.

Author information

1
1 Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts , Amherst, Massachusetts.
2
2 Baystate Health System , Springfield, Massachusetts.
3
3 Partners for a Healthier Community , Springfield, Massachusetts.
4
4 Department of Psychological and Brain Sciences, University of Massachusetts , Amherst, Massachusetts.
5
5 Baystate Medical Center , Springfield, Massachusetts.
6
6 Carolina Population Center, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.

Abstract

BACKGROUND:

Preterm birth and low birthweight contribute substantially to the disproportionately high infant mortality rates experienced by Puerto Ricans in the United States. The purpose of this study was to examine whether the timing and pattern of prenatal psychosocial stress increased risk of adverse birth outcomes in this high-risk population.

MATERIALS AND METHODS:

Proyecto Buena Salud was a prospective cohort study conducted from 2006 to 2011 among predominantly Puerto Rican women. Participants (n = 1,267) were interviewed in early, mid-, and late pregnancy. We evaluated associations between early and mid-pregnancy stress (Perceived Stress Scale) and preterm birth and low birthweight, and stress at each pregnancy time point and small for gestational age (SGA).

RESULTS:

Elevated levels of perceived stress in mid-pregnancy increased risk for preterm birth and low birthweight in adjusted analyses, with a linear trend observed for each increasing quartile of stress (ptrend = 0.01). Women in the highest quartile of stress experienced three times the risk for preterm birth (odds ratio [OR] = 3.50, confidence interval [95% CI]: 1.38-8.87) and low birthweight (OR = 3.53, 95% CI = 1.27-9.86) compared with women in the lowest quartile. Early pregnancy stress was not associated with preterm birth or low birthweight. Increase in stress from early to late pregnancy increased risk for SGA (OR = 1.90, 95% CI = 1.01-3.59); no associations were found between stress at any timepoint and SGA.

CONCLUSION:

Elevated levels of mid-pregnancy perceived stress increased risk for preterm birth and low birthweight, and an increase in stress over the course of pregnancy increased risk for SGA in a population of predominantly Puerto Rican women.

KEYWORDS:

Latina health; growth restriction; low birthweight; prematurity; preterm birth; small for gestational age; stress

PMID:
29215314
PMCID:
PMC5962329
DOI:
10.1089/jwh.2016.6118
[Indexed for MEDLINE]
Free PMC Article

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