Outcomes and health status of socially disadvantaged women during pregnancy

We sought to examine the health status of disadvantaged pregnant women more broadly and to consider if poor maternal health predisposes a woman to an adverse birth outcome. We surveyed 250 women recruited from six health cent ers in the greater Boston area during their third trimester. The main predi ctor variables were maternal physical functioning (PF), emotional health (E H), and overall health status in the month prior to pregnancy. The main out come variables were the decline of maternal PF and EH during pregnancy and adverse birth outcomes. Mean PF scores fell from 91.9 prior to pregnancy to 63.7 during the third trimester (mean scores transformed 0 to 100, where a higher score represents better health). EH remained unchanged during pregn ancy. After adjustment, women with a preexisting medical condition reported a lower PF score prior to pregnancy (87.8 versus 94.5, p < 0.05). Poor PF prior to pregnancy or during the third trimester was associated with an inc reased risk of preterm labor (odds ratio 2.02, 95% confidence interval 1.03 -3.97). This study is the first to employ general health status measures to examine changes in health during pregnancy. Our findings support the use o f preconception care to improve the health status of disadvantaged women wi th preexisting conditions. This study suggests that poor maternal health ma y predispose a woman to an increased risk of preterm labor.