Societal Factors in Pregnancy: Why Worry?Psychosocial Stress and Pregnancy OutcomeHOBEL, CALVIN J. MD; GOLDSTEIN, AMY MA, MPH, MFT; BARRETT, EMILY S. PhDAuthor Information Department of Obstetrics, Gynecology and Pediatrics, Division of Maternal Fetal Medicine, Burns and Allen Research Institute, Cedars Sinai Medical Center, The David Geffen School of Medicine at UCLA, Los Angeles, California Source Support: Miriam Jacobs Chair, Maternal Fetal Medicine, Cedars Sinai, NIH R-13 Community Child Health Network (2U01 HD044245-04). Correspondence: Calvin J. Hobel, MD, Department of Obstetrics, Gynecology and Pediatrics, Division of Maternal Fetal Medicine, Burns and Allen Research Institute, Cedars Sinai Medical Center, The David Geffen School of Medicine at UCLA, 8635 West 3rd St, Suite 160W, Los Angeles, CA 90048. E-mail: [email protected] Clinical Obstetrics and Gynecology: June 2008 - Volume 51 - Issue 2 - p 333-348 doi: 10.1097/GRF.0b013e31816f2709 Buy Metrics Abstract This article is intended to help clinicians better understand the ever-expanding body of research on whether psychosocial stress (both acute and chronic) is linked to 2 major adverse pregnancy outcomes: preterm birth and low birth weight. We summarize the existing literature and then review assessment tools commonly used to diagnose various types of psychosocial stress, with attention to how and when assessments should be made. After discussing the physiologic mechanisms hypothesized to underlie these relationships, we examine the range of existing interventions aimed at reducing psychosocial stress and review their efficacy at improving birth outcomes. Future directions for prevention of adverse pregnancy outcomes are discussed and suggest that an entirely new approach may be necessary. © 2008 Lippincott Williams & Wilkins, Inc.