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Maternal Prenatal Pregnancy-Related Anxiety and Spontaneous Preterm Birth in Baltimore, Maryland

Orr, Suezanne T. PhD; Reiter, Jerome P. PhD; Blazer, Dan G. MD, PhD; James, Sherman A. PhD

doi: 10.1097/PSY.0b013e3180cac25d
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Objective: To focus on the relationship between pregnancy-related anxiety and spontaneous preterm birth. Psychosocial factors have been the subject of inquiries about the etiology of preterm birth; a factor of recent interest is maternal prenatal pregnancy-related anxiety (worries and concerns related to the pregnancy).

Methods: From 1991 to 1993, a total of 1820 women completed the study questionnaire during their first prenatal visit to clinics in Baltimore, Maryland. Pregnancy-related anxiety was assessed using six questions from the Prenatal Social Environment Inventory; scores ranged from 0 to 6. Data on pregnancy outcome and clinical and behavioral covariates were obtained from the women’s clinical records.

Results: After adjustment for covariates (first or second trimester bleeding, drug use, employment, prior poor pregnancy outcome, smoking, low body mass index, maternal education, age, and race), women with higher levels of pregnancy-related anxiety (scores of 5 or 6) had a significantly increased risk of spontaneous preterm birth compared with those with scores of ≤3.

Conclusions: If additional research confirms these results, then this finding may suggest the possibility of intervention to reduce maternal prenatal pregnancy-related worries and concerns, thereby reducing the risk of spontaneous preterm birth.

PSEI = Prenatal Social Environment Inventory; CES-D = Center for Epidemiologic Studies Depression Scale; BMI = body mass index; OR = Odds Ratio.

From the Department of Health Education and Promotion (S.T.O.), College of Health and Human Performance, East Carolina University, Greenville, North Carolina; Institute of Statistics and Decision Sciences (J.P.R.), Duke University, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences (D.G.B.), Duke University Medical Center, Durham, North Carolina; Terry Sanford Institute for Policy Studies (S.A.J.), Duke University, Durham, North Carolina.

Address correspondence and reprint requests to Suezanne T. Orr, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 200 Christenbury, Greenville, NC 27858. E-mail: orrs@ecu.edu

Data collection and instrument development for this study were supported by Grant 1 R01-HD-25754 from the National Institute of Child Health and Human Development, National Institutes of Health.

Received for publication October 10, 2006; revision received April 2, 2007.

Copyright © 2007 by American Psychosomatic Society
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