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. 2021 Mar 20;55(3):242-252.
doi: 10.1093/abm/kaaa047.

Maternal Stress Before Conception Is Associated with Shorter Gestation

N E Mahrer  1   2 , C M Guardino  3 , C Hobel  4 , C Dunkel Schetter  1
Affiliations

Maternal Stress Before Conception Is Associated with Shorter Gestation

N E Mahrer et al. Ann Behav Med. .

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.

Keywords: Gestational length; Preconception; Preterm birth; Stress.

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Figures

Fig. 1.
Fig. 1.
Diagram of Community Child Health Network (CCHN) and subsequent child follow-up study design.
Fig. 2.
Fig. 2.
Maternal stress measurement model (N = 2,637).
Fig. 3.
Fig. 3.
Curvilinear (quadratic) association between preconception exposure to stressors and gestational length (n = 360). Range of graph is restricted to the range of gestational length in the current sample (23–42 weeks).
See this image and copyright information in PMC

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