Pregnancy-specific stress, prenatal health behaviors, and birth outcomes.

TLDR

Stress during pregnancy is associated with earlier delivery and lower birth weight. The study examined whether pregnancy‑specific stress uniquely predicts birth outcomes beyond general stress and whether prenatal health behaviors mediate this effect. Researchers assessed 279 pregnant women with structured interviews measuring multiple stress types and health behaviors, then used latent factor analysis to compare pregnancy‑specific stress with other stress constructs in predicting birth outcomes. Pregnancy‑specific stress was linked to adverse health behaviors and shorter gestation, directly increased preterm delivery risk, and indirectly lowered birth weight through smoking, outperforming general stress in predicting adverse birth outcomes.

Abstract

Stress in pregnancy predicts earlier birth and lower birth weight. The authors investigated whether pregnancy-specific stress contributes uniquely to birth outcomes compared with general stress, and whether prenatal health behaviors explain this association.Three structured prenatal interviews (N = 279) assessing state anxiety, perceived stress, life events, pregnancy-specific stress, and health behaviors.Gestational age at delivery, birth weight, preterm delivery (<37 weeks), and low birth weight (<2,500 g).A latent pregnancy-specific stress factor predicted birth outcomes better than latent factors representing state anxiety, perceived stress, or life event stress, and than a latent factor constructed from all stress measures. Controlling for obstetric risk, pregnancy-specific stress was associated with smoking, caffeine consumption, and unhealthy eating, and inversely associated with healthy eating, vitamin use, exercise, and gestational age at delivery. Cigarette smoking predicted lower birth weight. Clinically-defined birth outcomes were predicted by cigarette smoking and pregnancy-specific stress.Pregnancy-specific stress contributed directly to preterm delivery and indirectly to low birth weight through its association with smoking. Pregnancy-specific stress may be a more powerful contributor to birth outcomes than general stress.