Abstract
Objectives Studies examining risk factors for preterm birth (PTB) such as psychosocial stress are often focused on women with a history of PTB; however, most preterm babies are born to women with no history of preterm birth. Our objective was to determine if the relationship between psychosocial stress and PTB is altered by parity. Non-Hispanic black (NHB) women have increased psychosocial stress and PTB; therefore, we further aimed to determine if race alters the relationship between psychosocial stress, parity, and PTB. Methods We performed a secondary analysis of the Healthy Pregnancy, Healthy Baby Study comparing pregnant women who were primiparous (first pregnancy), multiparous with history of preterm birth, or multiparous with history of term birth. Perceived stress, perceived racism, interpersonal support, John Henryism and self-efficacy were measured using validated instruments. Logistic regression was used to model the effect of psychosocial stress on PTB stratified by parity and race. Results The analysis entire cohort included 1606 subjects, 426 were primiparous, 268 had a history of presterm birth, and 912 had a history of term birth. In women with a history of term birth, higher self-efficacy was associated with lower odds of spontaneous PTB, and this association was amplified in NHB women. In women with a history of spontaneous PTB, John Henryism Active Coping was associated with lower odds of spontaneous PTB in the index pregnancy. Conclusions for Practice The relationship between psychosocial stress and PTB may be mediated by parity and race.
Similar content being viewed by others
References
Arbour, M. W., Corwin, E. J., Salsberry, P. J., & Atkins, M. (2012). Racial differences in the health of childbearing-aged women. MCN: The American Journal of Maternal/Child Nursing, 37(4), 262–268. https://doi.org/10.1097/NMC.0b013e31824b544e.
Borg, F., Gravino, G., Schembri-Wismayer, P., & Calleja-Agius, J. (2013). Prediction of preterm birth. Minerva Ginecologica, 65(3), 345–360.
Cohen, S., et al. (1985) Measuring the functional components of social support. In I. G. Sarason & B. R. Sarason (Eds.) Social support: Theory, research, and applications (pp. 73–94). Dordrecht: Martinus Nijhoff.
Cohen, S., & Williamson, G. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan, S. Oskamp (Eds.) The social psychology of health. Newbury Park, CA: Sage.
Dekker, G. A., Lee, S. Y., North, R. A., McCowan, L. M., Simpson, N. A., & Roberts, C. T. (2012). Risk factors for preterm birth in an international prospective cohort of nulliparous women. PLoS ONE, 7(7), e39154. https://doi.org/10.1371/journal.pone.0039154.
Dole, N., Savitz, D. A., Siega-Riz, A. M., Hertz-Picciotto, I., McMahon, M. J., & Buekens, P. (2004). Psychosocial factors and preterm birth among African American and White women in central North Carolina. American Journal of Public Health, 94(8), 1358–1365.
Grobman, W. A., Parker, C., Wadhwa, P. D., Willinger, M., Simhan, H., & Silver, B., … Eunice Kennedy Shriver National Institute of Child Health Human Development nuMoM2b Network, B. M. D. (2016). Racial/ethnic disparities in measures of self-reported psychosocial states and traits during pregnancy. American Journal of Perinatology. https://doi.org/10.1055/s-0036-1586510.
Guendelman, S., Kosa, J. L., Pearl, M., Graham, S., & Kharrazi, M. (2008). Exploring the relationship of second-trimester corticotropin releasing hormone, chronic stress and preterm delivery. The Journal of Maternal-Fetal & Neonatal Medicine, 21(11), 788–795. https://doi.org/10.1080/14767050802379031.
James, S. (1996). The John Henryism Scale for active coping. In: R. Jones (Ed.) Handbook of tests and measurements for Black populations. Hampton, VA: Cobb & Henry Publishers
James, S. A. (1994). John Henryism and the health of African-Americans. Culture, Medicine and Psychiatry, 18(2), 163–182.
Jerusalem, M., Schwarzer, R. (1992). Self-efficacy as a resource factor in stress appraisal processes. In R. Schwarzer (Eds.) Self-efficacy: Thought control of action (pp. 195–213). Washington, DC: Hemisphere
Kazemier, B. M., Buijs, P. E., Mignini, L., Limpens, J., de Groot, C. J., Mol, B. W., & Ebm, C. (2014). Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: A systematic review. BJOG, 121(10), 1197–1208. https://doi.org/10.1111/1471-0528.12896 (discussion 1209).
Khashan, A. S., McNamee, R., Abel, K. M., Mortensen, P. B., Kenny, L. C., Pedersen, M. G., … Baker, P. N. (2009). Rates of preterm birth following antenatal maternal exposure to severe life events: A population-based cohort study. Human Reproduction, 24(2), 429–437. https://doi.org/10.1093/humrep/den418.
Kramer, M. R., Hogue, C. J., Dunlop, A. L., & Menon, R. (2011). Preconceptional stress and racial disparities in preterm birth: An overview. Acta Obstetricia et Gynecologica Scandinavica, 90(12), 1307–1316. https://doi.org/10.1111/j.1600-0412.2011.01136.x.
Kramer, M. S., Lydon, J., Seguin, L., Goulet, L., Kahn, S. R., McNamara, H., … Platt, R. W. (2009). Stress pathways to spontaneous preterm birth: The role of stressors, psychological distress, and stress hormones. American Journal of Epidemiology, 169(11), 1319–1326. https://doi.org/10.1093/aje/kwp061.
Laughon, S. K., Albert, P. S., Leishear, K., & Mendola, P. (2014). The NICHD Consecutive Pregnancies Study: Recurrent preterm delivery by subtype. American Journal of Obstetrics & Gynecology. https://doi.org/10.1016/j.ajog.2013.09.014.
Levine, T. A., Alderdice, F. A., Grunau, R. E., & McAuliffe, F. M. (2016). Prenatal stress and hemodynamics in pregnancy: A systematic review. Archives of Women’s Mental Health, 19(5), 721–739. https://doi.org/10.1007/s00737-016-0645-1.
Lu, M. C., & Chen, B. (2004). Racial and ethnic disparities in preterm birth: The role of stressful life events. American Journal of Obstetrics & Gynecology, 191(3), 691–699. https://doi.org/10.1016/j.ajog.2004.04.018.
March of Dimes 2017 Premature Birth Report Card. Retrieved from https://www.marchofdimes.org/mission/prematurity-reportcard.aspx.
Mathews, T. J., & MacDorman, M. F. (2013). Infant mortality statistics from the 2009 period linked birth/infant death data set. National Vital Statistics Reports, 61(8), 1–27.
Mercer, B. M., Goldenberg, R. L., Moawad, A. H., Meis, P. J., Iams, J. D., Das, A. F., … McNellis, D. (1999). The preterm prediction study: Effect of gestational age and cause of preterm birth on subsequent obstetric outcome. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. American Journal of Obstetrics & Gynecology, 181(5 Pt 1), 1216–1221.
Ruiz, R. J., Gennaro, S., O’Connor, C., Dwivedi, A., Gibeau, A., Keshinover, T., & Welsh, T. (2016). CRH as a predictor of preterm birth in minority women. Biological Research for Nursing, 18(3), 316–321. https://doi.org/10.1177/1099800415611248.
Acknowledgements
This research was supported by funding from the U.S. Environmental Protection Agency (RD-83329301-0).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wheeler, S., Maxson, P., Truong, T. et al. Psychosocial Stress and Preterm Birth: The Impact of Parity and Race. Matern Child Health J 22, 1430–1435 (2018). https://doi.org/10.1007/s10995-018-2523-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-018-2523-0