Online Program

Accumulation of stressful life events and low birth weight: The case of preconception stress and in utero exposure to 9/11

Tuesday, November 5, 2013

Kara Mandell, MA, Department of Population Health, University of Wisconsin-Madison, Madison, WI
Whitney P. Witt, PhD, MPH, Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
BACKGROUND: It is unknown how the 9/11 attacks affected infant birthweight in the context of preconception stressful life events (PSLEs). This study examined: 1) if and to what extent women's PSLEs moderated the effect of in utero exposure to 9/11 on birthweight; and, 2) if these relationships were stronger closer to the epicenter of the attacks.

METHODS: Data are from the Early Childhood Longitudinal Study – Birth Cohort (ECLS-B), a nationally representative cohort of women who gave birth to a live baby in 2001. We used multinomial logistic regression to examine the interaction between 9/11 and PSLEs on the odds of being born low birth weight (LBW) or very low birth weight (VLBW). We stratified this analysis to examine these relationships in the Northeast.

FINDINGS: We found no effect of 9/11 on infant birthweight; further PSLEs did not moderate the effect of 9/11 on birthweight. However, in the Northeast infants who were exposed in utero to 9/11 and whose mothers who were exposed to PSLEs were more likely to be born LBW (OR=3.23, 95% CI 1.42-7.36) or VLBW (OR=3.60, 95% CI: 1.49-8.74).

CONCLUSIONS: Exposure to PSLEs increased women's vulnerability to 9/11 during pregnancy in the Northeast region of the US. Women close the epicenter of a disaster and who have experienced PSLEs should receive priority services during pregnancy. Because it is difficult to provide services to those in need afterwards, it may be more effective to offer preventive interventions to reduce the deleterious effects of the accumulation of stress.

Learning Areas:

Public health or related research

Learning Objectives:
Describe the effects of 9/11 on obstetric outcomes across the United States and in the Northeast; Explain how maternal exposure to the accumulation of stressful life events prior to birth impacts birth weight; and, Discuss theoretical and policy implications of our findings.

Keyword(s): Stress, Birth Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am PI on the study from which these analyses were conducted. I also serve as co-director of BioPop: Integrative Biopsychosocial Research in Population Health and the Center for Women’s Health and Health Equity Research.
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.