Role of Perceived Stress in the Occurrence of Preterm Labor and Preterm Birth Among Urban Women
Article first published online: 29 MAY 2014
© 2014 by the American College of Nurse-Midwives
Journal of Midwifery & Womens Health
Volume 59, Issue 4, pages 374–379, July/August 2014
How to Cite
Seravalli, L., Patterson, F. and Nelson, D. B. (2014), Role of Perceived Stress in the Occurrence of Preterm Labor and Preterm Birth Among Urban Women. Journal of Midwifery & Womens Health, 59: 374–379. doi: 10.1111/jmwh.12088
- Issue published online: 25 JUL 2014
- Article first published online: 29 MAY 2014
- National Institutes of Health and National Institute of Child Health and Human Development. Grant Number: R01HD038856
- vulnerable populations;
- labor support;
- preventive health care;
- preterm labor;
- preterm birth
This study examined whether prenatal perceived stress levels during pregnancy were associated with preterm labor or preterm birth.
Perceived stress levels were measured at 16 weeks’ gestation or less and between 20 and 24 weeks’ gestation in a sample of 1069 low-income pregnant women attending Temple University prenatal care clinics. Scores were averaged to create a single measure of prenatal stress. Preterm birth was defined as the occurrence of a spontaneous birth prior to 37 weeks’ gestation. Preterm labor was defined as the occurrence of regular contractions between 20 and 37 weeks' gestation that were associated with changes in the cervix.
Independent of potential confounding factors, prenatal perceived stress was not associated with preterm labor (odds ratio [OR], 1.10; 95% confidence interval [CI], 0.69-1.78; P = .66); however, prenatal stress trended toward an association with preterm birth (OR, 1.49; 95% CI, 1.00-2.23; P = .05). The strongest predictor of preterm labor was a history of preterm labor in a prior pregnancy. Women with a history of preterm labor were 2 times more likely to experience preterm labor in the current pregnancy than women who did not have a preterm labor history (OR, 2.16; 95% CI, 1.05-4.41; P = .04). Historical risk factors for preterm birth, such as African American race, a history of abortion, or a history of preterm birth, were not related to preterm labor. The strongest predictor of preterm birth was having a history of preterm birth in a prior pregnancy (OR, 2.55; 95% CI, 1.54-4.24; P < .001).
Prenatal perceived stress levels may be a risk factor for preterm birth independent of preterm labor; however, prenatal stress was not associated with preterm labor. Risk factors for preterm labor may be different from those of preterm birth.