Maternal Stressors and Social Support as Risks for Delivering Babies with Structural Birth Defects
Article first published online: 3 APR 2014
© 2014 John Wiley & Sons Ltd
Paediatric and Perinatal Epidemiology
Volume 28, Issue 4, pages 338–344, July 2014
How to Cite
Carmichael, S. L., Ma, C., Tinker, S., Rasmussen, S. A., Shaw, G. M. and National Birth Defects Prevention Study (2014), Maternal Stressors and Social Support as Risks for Delivering Babies with Structural Birth Defects. Paediatric and Perinatal Epidemiology, 28: 338–344. doi: 10.1111/ppe.12123
- Issue published online: 12 JUN 2014
- Article first published online: 3 APR 2014
- NIH. Grant Numbers: R03 DE020112, CDC 6U01-DD-000489, 1U01-DD-0006982
- social support;
- birth defects
We examined the association of maternal stressful life events and social support with risks of birth defects using National Birth Defects Prevention Study data, a population-based case–control study.
We examined seven stressful life events and three social support questions applicable to the periconceptional period, among mothers of 552 cases with neural tube defects (NTDs), 413 cleft palate (CP), 797 cleft lip ± cleft palate (CLP), 189 d-transposition of the great arteries (dTGA), 311 tetralogy of Fallot (TOF), and 2974 non-malformed controls. A stressful life events index equalled the sum of ‘yes’ responses to the seven questions. Social support questions were also summed to form an index. Data were analyzed using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusted for maternal race-ethnicity, age, education, body mass index, smoking, drinking, and intake of vitamin supplements.
Associations with the stress index tended to be higher with higher scores, but few 95% CIs excluded one. A four-point increase in the index was moderately associated with NTDs (OR 1.5, [95% CI 1.1, 2.0]) and CLP (OR 1.3, [95% CI 1.0, 1.7]). The social support index tended to be associated with reduced risk but most 95% CIs included one, with the exception of dTGA (OR for a score of 3 vs 0 was 0.5 [95% CI 0.3, 0.8]).
Maternal periconceptional stressful life events, social support, and the two factors in combination were at most modestly, if at all, associated with risks of the studied birth defects.