Preconception stressful life events predict low infant birthweight among women in the United States
METHODS: We examined 8,700 mothers and infants participating in the Early Childhood Longitudinal Study-Birth Cohort. We defined exposure to SLEs as maternal report of death of a parent or previous child, divorce, being separated or widowed, or fertility problems prior to conception. Weighted regressions estimated the effect of exposure on very low (VLBW; <1,500 grams) and low (1,500-2,499 grams) birthweight, adjusting for maternal sociodemographic and health factors and stress during pregnancy.
RESULTS: 19.4% of women experienced any SLE prior to conception. In adjusted analyses, women who experienced any SLE prior to conception were 40% more likely to have a VLBW infant than women who did not (OR 1.40; 95% CI: 1.14-1.72). Furthermore, the accumulation of SLEs was associated with reduced infant birthweight.
CONCLUSIONS: This is the first nationally representative study to investigate the impact of SLEs prior to conception on infant birthweight in the U.S. Exposure to SLEs prior to conception increases the risk for having a VLBW infant. The effect of exposure to SLEs may accumulate over a woman's lifecourse to increase her risk for having a lower birthweight infant. Interventions to improve birth outcomes will need to shift the clinical practice paradigm upstream to the preconception period to reduce the impact of exposure to stress over the lifecourse and improve the long-term health of children.
Public health or related research
Social and behavioral sciences
Discuss the relationships between stressful life events prior to conception and the risk for having a very low birthweight infant. Discuss programmatic and policy implications of our findings.
Keyword(s): Low Birthweight, Stress
Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on the maternal and child health. Among my scientific interests has been the application of the life course approach to understanding the social, behavioral, and psychological factors that contribute to human development and disparities in health and healthcare in women, children, and families.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.