The preterm prediction study: Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation
The preterm prediction study: Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation
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DOI：
10.1016/s0002-9378(96)70042-x
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发表时间：
1996-11-01
影响因子：
9.8
通讯作者：
Dombrowski, MP
中科院分区：
文献类型：
--
作者：
Copper, RL;Goldenberg, RL;Dombrowski, MP
目的：我们的目的是要确定是否与自发性早产，胎儿生长受限，或低出生weight.Study设计：焦虑，压力，自尊，掌握和抑郁症的各种措施，在怀孕期间不良的心理状态进行了评估，在25至29周，在2593妊娠妇女使用28项Likert量表。确定每个心理社会分量表的评分，并计算总体心理社会评分。分数分为四分位数，最低的四分位数分数用于定义不良的心理社会状况。比较了低和高心理社会评分妇女的自发性早产、低出生体重和胎儿生长受限的百分比。Logistic回归分析提供了优势比和95%的置信区间。结果：分析显示，压力与自发性早产和低出生体重显著相关，优势比分别为1.16，p = 0.003和1.08，p = 0.02，分别为每个点的规模。综合量表或除压力外的任何子量表的低评分均不能预测自发性早产、胎儿生长受限或低出生体重。在对心理社会状态、物质使用和人口统计学特征进行多变量调整后，黑人种族是唯一与自发性早产、胎儿生长受限和低出生体重显著相关的变量;压力和低教育与自发性早产和低出生体重相关。即使在调整了母亲的人口统计学和行为特征后，压力仍与自发性早产和低出生体重有关。即使在调整了压力、物质使用和其他人口统计学因素后，黑人仍然是自发性早产、胎儿生长受限和低出生体重的重要预测因素。
OBJECTIVE: Our purpose was to determine whether various measures of poor psychosocial status in pregnancy are associated with spontaneous preterm birth, fetal growth restriction, or low birth weight.STUDY DESIGN: Anxiety, stress, self-esteem, mastery, and depression were assessed at 25 to 29 weeks in 2593 gravid women by use of a 28-item Likert scale. Scores for each psychosocial subscale were determined, and an overall psychosocial score was calculated. Scores were divided into quartiles, and the lowest quartile scores were used to define poor psychosocial status. The percent spontaneous preterm birth, low birth weight, and fetal growth restriction in women with low and high psychosocial scores were compared. Logistic regression analyses provided the odds ratios and 95% confidence intervals.RESULTS: Analyses revealed that stress was significantly associated with spontaneous preterm birth and with low birth weight with odds ratios of 1.16, p = 0.003, and 1.08, p = 0.02, respectively, for each point on the scale. A low score on the combined scale or on any subscale other than stress did not predict spontaneous preterm birth, fetal growth restriction, or low birth weight. After multivariate adjustment was performed for psychosocial status, substance use, and demographic traits, black race was the only variable significantly associated with spontaneous preterm birth, fetal growth restriction, and low birth weight; stress and low education were associated with spontaneous preterm birth and low birth weight.CONCLUSION: Stress was associated with spontaneous preterm birth and low birth weight even after adjustment for maternal demographic and behavioral characteristics. Black race continues to be a significant predictor of spontaneous preterm birth, fetal growth restriction, and low birth weight even after adjustment for stress, substance use, and other demographic factors.