The Effects of Stress on Birth Weight in Low-Income, Unmarried Black Women
Received 22 August 2008; received in revised form 17 July 2009; accepted 20 July 2009.
Objective
Low birth weight leads to adverse health outcomes throughout life, is particularly high among Blacks, and may contribute to health disparities between Whites and Blacks in the United States. Stress is among the many potential contributors to birth weight, but key sources of stress have not yet been clearly identified. The objective of this paper is to describe the relationships between multiple sources of maternal stress and birth weight.
Methods
Linear regression is used to analyze data from two control groups (n = 554) of the Nurse–Family Partnership trial in Memphis, Tennessee. Birth weight was obtained from medical records and other variables are from interviews during pregnancy (1990–1991). Four stresses were considered: abuse, anxiety, financial stress, and neighborhood disorganization.
Results
When the four sources of stress were included together in the same model and known non-stress-related influences were controlled for, only neighborhood was a significant contributor to birth weight. When each stress was entered into the model individually, abuse, anxiety, and neighborhood disorganization were all significant.
Conclusion
These results suggest that neighborhood disorganization has the most robust impact on birth weight, whereas abuse and anxiety seem to contribute via a source of shared variance. Further research is warranted to determine appropriate interventions.
aDepartment of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
Correspondence to: Peter Veazie, PhD, Department of Community and Preventive Medicine, University of Rochester, 601 Elmwood Ave, Box 644, Rochester, New York 14642; Phone: 585-273-5464; Fax: 585-461-4532.
M.L. Holland acknowledges support from an NRSA Institutional Research Training Grant (T32 HS000044-16) and a Health Services Research Dissertation Award (R36 HS017737), both from the Agency for Healthcare Research and Quality.
ABSTRACT