STRESS, SOCIAL SUPPORT AND PREGNANCY OUTCOME - A REASSESSMENT BASED ON RECENT RESEARCH

We present an assessment of studies published in the last decade that consider the relationship of stress and social support to preterm deli very or fetal growth retardation. Included in the review are all repor ts on the direct effects of stressors or psychological distress; the i ndirect effects of stressors or distress through health behaviours suc h as smoking; and the direct and buffering effects of social support. Although an important stimulus for recent stress research has been the attempt to explain racial and social class differences in birth outco me, the recent data show that stressful life events during pregnancy, though more common in disadvantaged groups, do not increase the risk o f preterm birth. In contrast, intimate social support from a partner o r family member appears to improve fetal growth, even for women with l ittle life stress. Questions unanswered by the research to date are wh ether elevated levels of depressive symptoms affect pregnancy outcome, either directly or by encouraging negative health behaviours, and whe ther chronic (vs. acute) stressors are harmful. Additional research is also needed to determine whether psychosocial factors interact with s pecific clinical conditions to promote adverse pregnancy outcomes. Foc using on intimate support and how it benefits pregnancy outcome could lead to the design of more effective interventions.