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Infant birthweight in the US: the role of preconception stressful life events and substance use

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Abstract

The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women’s alcohol and tobacco use before and during pregnancy, and infant birthweight. Data were from the Early Childhood Longitudinal Study-Birth Cohort (n = 9,350). Data were collected in 2001. Exposure to PSLEs was defined by indications of death of a parent, spouse, or previous live born child; divorce or marital separation; or fertility problems prior to conception. Survey data determined alcohol and tobacco usage during the 3 months prior to and in the final 3 months of pregnancy. We used staged multivariable logistic regression to estimate the effects of women’s substance use and PSLEs on the risk of having a very low (<1,500 g, VLBW) or low (1,500–2,499 g, LBW) birthweight infant, adjusting for confounders. Women who experienced any PSLE were more likely to give birth to VLBW infants (adjusted odds ratio [AOR] = 1.35; 95 % confidence interval [CI] = 1.10–1.66) than women who did not experience any PSLE. Compared to women who never smoked, women who smoked prior to conception (AOR = 1.31; 95 % CI = 1.04–1.66) or during their last trimester (AOR = 1.98; 95 % CI = 1.56–2.52) were more likely to give birth to LBW infants. PSLEs and women’s tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby. Interventions to improve birth outcomes may need to address women’s health and health behaviors in the preconception period.

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Notes

  1. While this relationship did not achieve statistical significance, it is suggestive of an association.

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Acknowledgments

This project was made possible by a Health Resources and Services Administrative (HRSA) (WPW, LEW, and DC—R40MC23625; PI—WP Witt) grant. Additional funding for this research was provided by grants from the Agency for Healthcare Research and Quality (KM and LEW—T32 HS00083; PI—M. Smith), the Health Disparities Research Scholars Program (FW—T32 HD049302; PI—G. Sarto), the 2012–2013 Herman I. Shapiro Distinguished Graduate Fellowship (LEW), and the Science and Medicine Graduate Research Scholars Fellowship from the University of Wisconsin in the College of Agriculture and Life Sciences and the School of Medicine and Public Health (ERC). ER Cheng was additionally supported by a National Research Service Award institutional training grant (T32HD075727-01; PI—JA Finkelstein). LE Wisk was additionally supported by the Thomas O. Pyle Fellowship and an Agency for Healthcare Research and Quality Postdoctoral Training Grant (T32HS000063-20; PI—JA Finkelstein). D. Chatterjee was additionally supported by a National Research Service Award (NRSA) in Primary Medical Care training grant (T32HP22239; PI—I. Borowsky).

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Authors and Affiliations

  1. Center for Maternal and Child Health Research, Truven Health Analytics, Inc, 4819 Emperor Boulevard, Suite 125, Durham, NC, 27703, USA

    Whitney P. Witt

  2. CNA, Arlington, VA, USA

    Kara C. Mandell

  3. Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Harvard Medical School and Boston Children’s Hospital, Boston, MA, USA

    Lauren E. Wisk

  4. Department of Pediatrics, Section of Children’s Health Services Research, Indiana University School of Medicine, Indianapolis, IN, USA

    Erika R. Cheng

  5. Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota–Twin Cities, Minneapolis, MN, USA

    Debanjana Chatterjee

  6. Ferris State University’s College of Health Professions, Big Rapids, MI, USA

    Fathima Wakeel

  7. Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

    Hyojun Park

  8. Department of Psychology, University of Wisconsin, Madison, WI, USA

    Dakota Zarak

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  1. Whitney P. Witt
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  2. Kara C. Mandell
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  8. Dakota Zarak
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Correspondence to Whitney P. Witt.

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Appendix 1

Appendix 1

Table 4 Results of multinomial logistic regression modeling high birthweighta predicted by stressful life events prior to conception, alcohol and tobacco use, maternal health, and sociodemographic factors
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Witt, W.P., Mandell, K.C., Wisk, L.E. et al. Infant birthweight in the US: the role of preconception stressful life events and substance use. Arch Womens Ment Health 19, 529–542 (2016). https://doi.org/10.1007/s00737-015-0595-z

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