Maternal Stress and Preterm Birth

TLDR

The study aimed to assess how psychosocial factors such as life events, social support, depression, pregnancy‑related anxiety, perceived discrimination, and neighborhood safety influence preterm birth risk. Researchers conducted a prospective cohort study of 1,962 pregnant women in central North Carolina from 1996 to 2000, collecting these psychosocial measures and tracking birth outcomes. Women with high pregnancy‑related anxiety, negatively weighted life events, or perceived racial discrimination had significantly higher preterm birth rates (RR 2.1–1.4), while social support and depression showed no association; anxiety also predicted labor‑initiated preterm birth (RR 3.0), and the association was attenuated but persisted among women without medical comorbidities, indicating that only a subset of psychosocial factors are linked to preterm birth.

Abstract

This study examined a comprehensive array of psychosocial factors, including life events, social support, depression, pregnancy-related anxiety, perceived discrimination, and neighborhood safety in relation to preterm birth (<37 weeks) in a prospective cohort study of 1,962 pregnant women in central North Carolina between 1996 and 2000, in which 12% delivered preterm. There was an increased risk of preterm birth among women with high counts of pregnancy-related anxiety (risk ratio (RR) = 2.1, 95% confidence interval (CI): 1.5, 3.0), with life events to which the respondent assigned a negative impact weight (RR = 1.8, 95% CI: 1.2, 2.7), and with a perception of racial discrimination (RR = 1.4, 95% CI: 1.0, 2.0). Different levels of social support or depression were not associated with preterm birth. Preterm birth initiated by labor or ruptured membranes was associated with pregnancy-related anxiety among women assigning a high level of negative impact weights (RR = 3.0, 95% CI: 1.7, 5.3). The association between high levels of pregnancy-related anxiety and preterm birth was reduced when restricted to women without medical comorbidities, but the association was not eliminated. The prospective collection of multiple psychosocial measures on a large population of women indicates that a subset of these factors is associated with preterm birth.