Cited by 848Maternal Mental Health During Pregnancy and PostpartumPreterm Birth and ChorioamnionitisMaternal and Neonatal Healthcare

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Maternal Stress and Preterm Birth

Dole, N.·2003·American Journal of Epidemiology

DOI 10.1093/aje/kwf176

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Abstract

This study examined a comprehensive array of psychosocial factors, including life events, social support, depression, pregnancy-related anxiety, perceived discrimination, and neighborhood safety in relation to preterm birth (<37 weeks) in a prospective cohort study of 1,962 pregnant women in central North Carolina between 1996 and 2000, in which 12% delivered preterm. There was an increased risk of preterm birth among women with high counts of pregnancy-related anxiety (risk ratio (RR) = 2.1, 95% confidence interval (CI): 1.5, 3.0), with life events to which the respondent assigned a negative impact weight (RR = 1.8, 95% CI: 1.2, 2.7), and with a perception of racial discrimination (RR = 1.4, 95% CI: 1.0, 2.0). Different levels of social support or depression were not associated with preterm birth. Preterm birth initiated by labor or ruptured membranes was associated with pregnancy-related anxiety among women assigning a high level of negative impact weights (RR = 3.0, 95% CI: 1.7, 5.3). The association between high levels of pregnancy-related anxiety and preterm birth was reduced when restricted to women without medical comorbidities, but the association was not eliminated. The prospective collection of multiple psychosocial measures on a large population of women indicates that a subset of these factors is associated with preterm birth.

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Authors: Dole, N.
Affiliations: University of North Carolina at Chapel Hill (US)
Corresponding author: Dole, N.
ORCID: Dole, N.
Venue: American Journal of Epidemiology
Publisher: Oxford University Press (OUP)
Published: 2003-01-01
Volume: 157
Issue: 1
Pages: 14-24
ISSN: 0002-9262 (ISSN-L)
DOI: 10.1093/aje/kwf176
OpenAlex: W2100384166
Cited by: 848
References: 60
Citations by year: 2026: 13 · 2025: 18 · 2024: 22 · 2023: 26 · 2022: 40 · 2021: 28 · 2020: 47 · 2019: 54 · 2018: 48 · 2017: 30 · 2016: 35 · 2015: 52 · 2014: 54 · 2013: 38 · 2012: 51
FWCI: 17.07
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Epidemiology (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Public Health Service (S455/16-17, S0807-18/20, S1099-19/21)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD28684, R01HD028684)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Health Sciences › Medicine › Obstetrics and Gynecology › Preterm Birth and Chorioamnionitis
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Keywords: preterm birth, maternal stress, pregnancy-related anxiety, life events, social support, depression, perceived racial discrimination, neighborhood safety, membrane rupture, labor, psychosocial risk factors, pregnancy outcomes
MeSH terms: Adolescent, Adult, Anxiety, Black or African American, Female, Humans, Obstetric Labor, Premature, Life Change Events, Life Style, Mothers, North Carolina, Pregnancy, Pregnancy Complications, Prejudice, Prospective Studies, Surveys and Questionnaires, Residence Characteristics, Risk Factors, Social Support, Stress, Psychological, Comorbidity, Multivariate Analysis, White People

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