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Stressors Across the Life-Course and Preterm Delivery: Evidence From a Pregnancy Cohort.
- Source :
- Maternal & Child Health Journal; Mar2017, Vol. 21 Issue 3, p648-658, 11p
- Publication Year :
- 2017
-
Abstract
- 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 = 2559). 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- RISK factors in premature labor
CHI-squared test
CHILD abuse
CHILD sexual abuse
CONFIDENCE intervals
GESTATIONAL age
LONGITUDINAL method
EVALUATION of medical care
MULTIVARIATE analysis
PREGNANCY
QUESTIONNAIRES
RESEARCH funding
RISK assessment
SEX crimes
STATISTICS
PSYCHOLOGICAL stress
SUBSTANCE abuse
MULTIPLE regression analysis
SECONDARY analysis
SOCIOECONOMIC factors
RETROSPECTIVE studies
PARITY (Obstetrics)
DESCRIPTIVE statistics
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 10927875
- Volume :
- 21
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Maternal & Child Health Journal
- Publication Type :
- Academic Journal
- Accession number :
- 121919502
- Full Text :
- https://doi.org/10.1007/s10995-016-2151-5