Abstract
Purpose
Prenatal stress is a known risk for poor birth outcomes. This study specifically looked at reported stress during pregnancy and low birth weight (LBW) in Rhode Island.
Methods
Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2016 to 2018 for the state of Rhode Island was utilized. Stress during most recent pregnancy was dichotomized as: ‘none to minimal’ and ‘moderate to high.’ LBW was defined as less than 2,500 g. Multivariable regression analysis was performed, accounting for complex survey design.
Results
In this cohort, 24% of pregnant people reported moderate to high stress leading to an adjusted odds of 1.70 (95% CI 1.43–2.03) of having a LBW newborn compared to those with none to minimal stress. Primiparity, previous preterm birth, racism, smoking history, and history of chronic medical problems were also associated with LBW newborns.
Conclusion
We recommend screening and provision of support services for stress in all settings where pregnant people access care.
Significance statement
Stress during pregnancy has been highlighted as a risk for poor birth outcomes. There are different measurements of prenatal stress ranging from stressful life events (SLEs) to direct pregnancy related stress, which have differential impacts on perinatal health. In our study, pregnant people who reported moderate to high stress were more likely to have LBW newborns compared to those who reported none to minimal stress. This study assessed self-reported stress during pregnancy as opposed to discrete SLE or chronic stressors.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alhusen, J. L., Ray, E., Sharps, P., & Bullock, L. (2015). Intimate partner Violence during pregnancy: Maternal and neonatal outcomes. Journal of Women’s Health, 24(1), 100–106. https://doi.org/10.1089/jwh.2014.4872.
Alves, A. C., Cecatti, J. G., & Souza, R. T. (2021). Resilience and stress during pregnancy: A comprehensive multidimensional approach in maternal and perinatal health. Scientific World Journal, 2021. https://doi.org/10.1155/2021/9512854.
Andermann, A. (2018). Screening for social determinants of health in clinical care: Moving from the margins to the mainstream. Public Health Reviews (Vol, 39, https://doi.org/10.1186/s40985-018-0094-7. Issue 1). BioMed Central Ltd.
Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C., & Braveman, P. A. (2010). Socioeconomic disparities in adverse birth outcomes: A systematic review. In American Journal of Preventive Medicine (Vol. 39, Issue 3, pp. 263–272). Elsevier Inc. https://doi.org/10.1016/j.amepre.2010.05.012.
Burns, E. R., Farr, S. L., Howards, P. P., & Centers for Disease Control and Prevention (CDC). (2015). Stressful life events experienced by women in the year before their infants’ births–United States, 2000–2010. MMWR Morbidity and Mortality Weekly Report, 64(9), 247–251. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6409a3.htm.
Copeland, D. B., & Harbaugh, B. L. (2019). It’s hard being a mama: Validation of the maternal distress Concept in becoming a mother. The Journal of Perinatal Education, 28(1), 28–42. https://doi.org/10.1891/1058-1243.28.1.28.
Copper, R. L., Goldenberg, R. L., Das, A., Elder, N., Swain, M., Norman, G., Ramsey, R., Cotroneo, P., Collins, B. A., Johnson, F., Jones, P., Meier, A., Roberts, J. M., Hauth, J. C., Northen, A., Meis, P. J., Mueller-Heubach, E., Frye, A., & Mowad, A. H. (1996). The preterm prediction study: Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks’ gestation. American Journal of Obstetrics and Gynecology, 175(5), 1286–1292. https://doi.org/10.1016/S0002-9378(96)70042-X.
Damron, K. R. (2017). Review of the relationships among psychosocial stress, secondhand smoke, and Smoking. JOGNN - Journal of Obstetric Gynecologic and Neonatal Nursing, 46(3), 325–333. https://doi.org/10.1016/J.JOGN.2017.01.012/ATTACHMENT/9B504451-646A-44DE-A7BA-AD3C14BD7190/MMC1.PDF.
Ding, X., Liang, M., Wu, Y., Zhao, T., Qu, G., Zhang, J., Zhang, H., Han, T., Ma, S., & Sun, Y. (2021). The impact of prenatal stressful life events on adverse birth outcomes: A systematic review and meta-analysis. Journal of Affective Disorders, 287, 406–416. https://doi.org/10.1016/J.JAD.2021.03.083.
DiPietro Mager, N. A. (2016). Stressful life events and pregnancy outcomes. Archives of Women’s Mental Health, 19(3), 559. https://doi.org/10.1007/S00737-016-0630-8.
Fatima, M., Srivastav, S., & Mondal, A. C. (2017). Prenatal stress and depression associated neuronal development in neonates. International Journal of Developmental Neuroscience, 60(1), 1–7. https://doi.org/10.1016/J.IJDEVNEU.2017.04.001.
Goldenberg, R. L., & Culhane, J. F. (2007). Low birth weight in the United States. American Journal of Clinical Nutrition, 85(2), 584S–590S. https://doi.org/10.1093/ajcn/85.2.584s.
Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008). Epidemiology and causes of preterm birth. In The Lancet (Vol. 371, Issue 9606, pp. 75–84). Elsevier. https://doi.org/10.1016/S0140-6736(08)60074-4.
Guedes, M., & Canavarro, M. C. (2014). Risk knowledge and psychological distress during pregnancy among Primiparous women of Advanced Age and their partners. Journal of Midwifery & Women’s Health, 59(5), 483–493. https://doi.org/10.1111/JMWH.12205.
Hobel, C. J., Goldstein, A., & Barrett, E. S. (2008). Psychosocial stress and pregnancy outcome. Clinical Obstetrics and Gynecology, 51(2), 333–348. https://doi.org/10.1097/GRF.0b013e31816f2709.
Hughes, M. M., Black, R. E., & Katz, J. (2017). 2500-g low Birth Weight Cutoff: History and implications for Future Research and Policy. Maternal and Child Health Journal, 21(2), 283–289. https://doi.org/10.1007/s10995-016-2131-9.
Lett, E., Asabor, E., Beltrán, S., Cannon, A. M., & Arah, O. A. (2022). Conceptualizing, contextualizing, and Operationalizing Race in Quantitative Health Sciences Research. The Annals of Family Medicine, 2792. https://doi.org/10.1370/AFM.2792.
Lobel, M., Dunkel-Schetter, C., & Scrimshaw, S. C. (1992). Prenatal maternal stress and prematurity: A prospective study of socioeconomically disadvantaged women. Health Psychology: Official Journal of the Division of Health Psychology American Psychological Association, 11(1), 32–40. https://doi.org/10.1037/0278-6133.11.1.32.
Muzik, M., Marcus, S. M., Heringhausen, J. E., & Flynn, H. (2009). When Depression Complicates Childbearing: Guidelines for Screening and Treatment During Antenatal and Postpartum Obstetric Care. In Obstetrics and Gynecology Clinics of North America (Vol. 36, Issue 4, pp. 771–788). NIH Public Access. https://doi.org/10.1016/j.ogc.2009.10.006.
Newton, R. W., Webster, P. A. C., Binu, P. S., Maskrey, N., & Phillips, A. B. (1979). Psychosocial stress in pregnancy and its relation to the onset of premature labour. British Medical Journal, 2(6187), 411. https://doi.org/10.1136/BMJ.2.6187.411.
O’Doherty, L., Hegarty, K., Ramsay, J., Davidson, L. L., Feder, G., & Taft, A. (2015). Screening women for intimate partner violence in healthcare settings. In Cochrane Database of Systematic Reviews (Vol. 2015, Issue 7). John Wiley and Sons Ltd. https://doi.org/10.1002/14651858.CD007007.pub3.
Rao, C. R., de Ruiter, L. E. E., Bhat, P., Kamath, V., Kamath, A., & Bhat, V. (2014). A Case-Control Study on Risk Factors for Preterm Deliveries in a Secondary Care Hospital, Southern India. ISRN Obstetrics and Gynecology, 2014, 1–5. https://doi.org/10.1155/2014/935982.
Romero, R., Dey, S. K., & Fisher, S. J. (2014). Preterm labor: One syndrome, many causes. Science (Vol. 345, pp. 760–765). American Association for the Advancement of Science. 6198https://doi.org/10.1126/science.1251816.
Savitz, D. A., Blackmore, C. A., & Thorp, J. M. (1991). Epidemiologic characteristics of preterm delivery: Etiologic heterogeneity. American Journal of Obstetrics and Gynecology, 164(2), 467–471. https://doi.org/10.1016/S0002-9378(11)80001-3.
Schappin, R., Wijnroks, L., Uniken Venema, M. M. A. T., & Jongmans, M. J. (2013). Rethinking stress in parents of Preterm infants: A Meta-analysis. Plos One, 8(2), https://doi.org/10.1371/journal.pone.0054992.
Schetter, C. D., & Tanner, L. (2012). Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. https://doi.org/10.1097/YCO.0b013e3283503680.
Shulman, H. B., D’Angelo, D. V., Harrison, L., Smith, R. A., & Warner, L. (2018). The pregnancy risk Assessment Monitoring System (PRAMS): Overview of design and methodology. American Journal of Public Health, 108(10), 1305–1313. https://doi.org/10.2105/AJPH.2018.304563.
StataCorp. (2017). Stata Statistical Software: Release 15. StataCorp LLC.
Witt, W. P., Litzelman, K., Cheng, E. R., Wakeel, F., & Barker, E. S. (2014). Measuring stress before and during pregnancy: A review of population-based studies of obstetric outcomes. Maternal and Child Health Journal, 18(1), 52–63. https://doi.org/10.1007/S10995-013-1233-X/TABLES/3.
Yang, L., Zhao, Y., Wang, Y., Liu, L., Zhang, X., Li, B., & Cui, R. (2015). The effects of psychological stress on Depression. Current Neuropharmacology, 13(4), 494. https://doi.org/10.2174/1570159X1304150831150507.
Zhu, P., Tao, F., Hao, J., Sun, Y., & Jiang, X. (2010). Prenatal life events stress: Implications for preterm birth and infant birthweight. American Journal of Obstetrics and Gynecology, 203(1), 34.e1-34.e8. https://doi.org/10.1016/J.AJOG.2010.02.023.
Funding
The authors have no relevant financial or non-financial interests to disclose.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Compliance with Ethical Standards
This analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data did not involve human participants and/or animals or informed consent.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Bloom, M., Gjelsvik, A. & Amanullah, S. Stress During Pregnancy Associated with Newborn Low Birth Weight: Experiences from the State of Rhode Island. Matern Child Health J 28, 344–350 (2024). https://doi.org/10.1007/s10995-023-03845-8
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-023-03845-8