Maternal Stress Before Conception Is Associated with Shorter Gestation

• Published in: Annals of behavioral medicine 2021-03, Vol.55 (3), p.242-252
• Main Authors: Mahrer, N E, Guardino, C M, Hobel, C, Dunkel Schetter, C
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Clinical outcomes; Factor Analysis, Statistical; Female; Gestational age; Health behavior; Health psychology; Humans; Latent Class Analysis; Longitudinal Studies; Mothers - psychology; Pregnancy; Regular; Stress; Stress, Psychological; United States - epidemiology; Womens health; Young Adult
• ISSN: 0883-6612; 1532-4796
• DOI: 10.1093/abm/kaaa047

Abstract Background Stress in pregnancy predicts adverse birth outcomes. Stressors occurring prior to conception may also pose risk for the mother and child. The few published studies on preconception stress test a single stress measure and examine only linear associations with birth outcomes. Purpose Guided by findings in the prenatal stress literature, the current study aimed to (i) identify latent factors from a set of preconception stress measures and (ii) examine linear and curvilinear associations between these stress factors and length of gestation. Methods Study 1 utilized a sample of 2,637 racially/ethnically diverse women to develop a measurement model of maternal stress from assessments of seven acute and chronic stress measures. Factor analysis revealed three latent factors representing stressors (life events, financial strain, interpersonal violence, discrimination), stress appraisals (perceived stress, parenting stress), and chronic relationship stress (family, partner stress). Study 2 examined the associations of these three latent preconception stress factors with the length of gestation of a subsequent pregnancy in the subset of 360 women who became pregnant within 4.5 years. Results Controlling for prenatal medical risks, there was a significant linear effect of stress appraisals on the length of gestation such that more perceived stress was associated with shorter gestation. There was a curvilinear effect of stressors on the length of gestation with moderate levels associated with longer gestation. Conclusions These results have implications for research on intergenerational origins of developmental adversities and may guide preconception prevention efforts. Findings also inform approaches to the study of stress as a multidimensional construct. Greater perceived stress prior to pregnancy is associated with earlier births, but exposure to moderate levels of environmental stressors preconception is associated with the longest gestation.