PSYCHOSOCIAL STRESSORS AND LOW-BIRTH-WEIGHT IN AN URBAN-POPULATION

Introduction: Low birthweight is a major determinant of infant mortali ty, as well as a contributor to infant and childhood morbidity. A key issue is how to reduce the incidence of low birthweight in the United States. One emerging factor is exposure to psychosocial stressors. In this research, we evaluated the association between exposure to psycho social stressors and low birthweight in a population of urban, low-inc ome pregnant women. Methods: Over 2,000 pregnant women 18 years of age and older were enrolled in this prospective study and recruited at th eir first prenatal care visit. We obtained information on maternal exp osure to stressors. After the pregnancy, we abstracted clinical record s of each woman enrolled in the study. Logistic regression was used to estimate the adjusted odds ratio for the association between stressor group membership and low birthweight, controlling for the effects of confounding factors. Results: In logistic regression analyses stratifi ed by race, for African-American women, the following variables were s ignificantly associated with low birthweight: smoking, hypertension, l ow prepregnancy weight, hospitalization during pregnancy, previous pre term birth, and exposure to stressors. For Caucasian women, significan t predictors were: smoking, drug use, hospitalization during pregnancy , hypertension, and previous preterm birth. Exposure to stressors was also significantly associated with many clinical and behavioral risks for low birthweight. Conclusion: Our results suggest two potential mec hanisms for an association between stressors and low birthweight. Expo sure to stressors may be indirectly associated with low birthweight th rough a relationship with clinical and behavioral risks for low birthw eight. Exposure to psychosocial stressors may also be directly associa ted with risk of low birthweight among African-American women.