Stressors across the life-course and preterm delivery: evidence from a pregnancy cohort

Details

• Alternative Title:
  Matern Child Health J
• Personal Author:
  Margerison-Zilko, Claire E. ; Strutz, Kelly L. ; Li, Yu ; Holzman, Claudia
• 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.
  
  
• Subjects:
  Adult Cohort Studies Female Gestational Age Humans Infant, Newborn Michigan Pregnancy Pregnancy Outcome Premature Birth Retrospective Studies Risk Stress, Psychological Surveys And Questionnaires

  More +
• Keywords:
  Abuse Life Course Preterm Delivery Stress
• Source:
  Matern Child Health J. 21(3):648-658
• Pubmed ID:
  27443654
• Pubmed Central ID:
  PMC5253130
• Document Type:
  Journal Article
• Funding:
  K01 HL128843/HL/NHLBI NIH HHSUnited States/ ; R01 HD034543/HD/NICHD NIH HHSUnited States/ ; U01 DP000143/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  21
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:42dfe08414efad7738ec4aa2127d44caa1d80e2034bf93781aa8b91b34c4a433
• Download URL:
  https://stacks.cdc.gov/view/cdc/43929/cdc_43929_DS1.pdf
• File Type:
  [PDF - 117.08 KB ]