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Stressors across the life-course and preterm delivery: evidence from a pregnancy cohort
  • Published Date:
    Mar 2017
  • Source:
    Matern Child Health J. 21(3):648-658.


Public Access Version Available on: March 01, 2018 information icon
Please check back on the date listed above.
Details:
  • Pubmed ID:
    27443654
  • Pubmed Central ID:
    PMC5253130
  • Description:
    Objectives

    Growing evidence suggests that pre-conception stressors are associated with increased risk of preterm delivery (PTD). Our study assesses stressors in multiple domains at multiple points in the life course (i.e., childhood, adulthood, within 6 months of pregnancy) and their relation to PTD. We also examine heterogeneity of associations by race/ethnicity, PTD timing, and PTD clinical circumstance.

    Methods

    We assessed stressors retrospectively via mid-pregnancy questionnaires in the Pregnancy Outcomes and Community Health Study (1998-2004), a Michigan pregnancy cohort (n=2,559). Stressor domains included abuse/witnessing violence (hereafter “abuse”), loss, economic stress, and substance use. We used logistic and multinomial regression for the following outcomes: PTD (<37 weeks’ gestation), PTD by timing (≤34 weeks, 35-36 weeks) and PTD by clinical circumstance (medically indicated, spontaneous). Covariates included race/ethnicity, education, parity, and marital status.

    Results

    Stressors in the previous 6 months were not associated with PTD. Experiencing abuse during both childhood and adulthood increased adjusted odds of PTD among women of white or other race/ethnicity only (aOR: 1.6, 95%CI: 1.1, 2.5). Among all women, abuse in childhood increased odds of late PTD (aOR: 1.5, 95%CI: 1.0, 2.2) while abuse in both childhood and adulthood non-significantly increased odds of early PTD (aOR: 1.6, 95%CI: 0.9, 2.7). Sexual, but not physical, abuse in both childhood and adulthood increased odds of PTD (aOR: 1.9, 95%CI: 1.0, 3.5).

    Conclusions

    Experiences of abuse—particularly sexual abuse—across the life-course may be important considerations when assessing PTD risk. Our results motivate future studies of pathways linking abuse and PTD.

  • Document Type:
  • Collection(s):
  • Funding:
    K01 HL128843/HL/NHLBI NIH HHS/United States
    R01 HD034543/HD/NICHD NIH HHS/United States
    U01 DP000143/DP/NCCDPHP CDC HHS/United States
  • Supporting Files:
    No Additional Files
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