The Relationships of Health Behaviour and Psychological Characteristics with Spontaneous Preterm Birth in Nulliparous Women

Abstract

Objectives Preterm birth is the leading pregnancy outcome associated with perinatal morbidity and mortality and remains difficult to prevent. There is evidence that some modifiable maternal health characteristics may influence the risk of preterm birth. Our aim was to investigate the relationships of self-reported maternal health behaviour and psychological characteristics in nulliparous women with spontaneous preterm birth in prenatal primary care. Methods The data of our prospective study was obtained from the nationwide DELIVER multicentre cohort study (September 2009–March 2011), which was designed to examine perinatal primary care in the Netherlands. In our study, consisting of 2768 nulliparous women, we estimated the relationships of various self-reported health behaviours (smoking, alcohol consumption, folic acid supplementation, daily fruit, daily fresh vegetables, daily hot meal and daily breakfast consumption) and psychological characteristics (anxious/depressed mood and health control beliefs) with spontaneous preterm birth as a dichotomous outcome. Due to the clustering of clients within midwife practices, Generalized Estimating Equations was used for these analyses. Results Low health control beliefs was the sole characteristic significantly associated with spontaneous preterm birth (odds ratio 2.26; 95 % confidence interval 1.51, 3.39) after being adjusted for socio-demographics, anthropometrics and the remaining health behaviour and psychological characteristics. The other characteristics were not significantly associated with spontaneous preterm birth. Conclusions for Practice Maternal low health control beliefs need to be explored further as a possible marker for women at risk for preterm birth, and as a potentially modifiable characteristic to be used in interventions which are designed to reduce the risk of spontaneous preterm birth.

Alcohol Intake in Early Pregnancy and Spontaneous Preterm Birth: A Cohort Study

“…A number of studies published after this meta‐analysis including 2 large cohorts found that any alcohol intake was associated with higher risk of preterm birth (Aliyu et al, ; Miyake et al, ; Nykjaer et al, ; Salihu et al, ). However, other recent studies found no association (Baron et al, ; Cooper et al, ; Dale et al, ; Lundsberg et al, ; McCarthy et al, ; Meyer‐Leu et al, ; Sbrana et al, ; Smith et al, ; Strandberg‐Larsen et al, ), and one study indicated lower risk among drinkers compared to nondrinkers (Pfinder et al, ), which is in accordance with previous studies suggesting an apparently beneficial effect of a low‐to‐moderate alcohol intake (Albertsen et al, ; Jaddoe et al, ; Kesmodel et al, ). It has been discussed whether these findings may be due to residual confounding (the healthy drinker effect) caused by the inability to adjust for lifestyle and socioeconomic factors (Bailey and Sokol, ; Henderson et al, ; Henderson et al, ; Patra et al, ; Pfinder et al, ).…”

“…Few studies have focused on spontaneous preterm birth in relation to maternal alcohol consumption (Adams et al, ; Aliyu et al, ; Baron et al, ; Harlow et al, ; Kesmodel et al, ; Kramer et al, ; McCarthy et al, ; Peacock et al, ). While most of these studies found no association, one study reported higher risk of spontaneous preterm birth among women with an intake of 10 or more drinks per week (Kesmodel et al, ).…”

Differences of Maternal Sociodemographic Characteristics With Spontaneous Preterm Birth Among Hospitals in Indonesia: A Comparative Study

“…Rallis et al, (2014) said that higher depression scores in early pregnancy were proven to predict anxiety and higher stress values in late pregnancy. According to Baron et al, (2016) mothers who consumed cigarettes ≥10 cigarettes per day were associated with preterm birth (OR 2.44; CI 95% 1.11-5.37) compared to mothers who consumed cigarettes ≤10 cigarettes per day (OR 1.07; 95% CI 0.57-2.00).…”

Modeling Differential Effects of Maternal Dietary Patterns across Severity Levels of Preterm Birth Using a Partial Proportional Odds Model

“…Maternal nutrition has an effect on fetal growth [13][14][15][16] and preterm deliveries [17][18][19][20][21] . Several studies have yielded varying results concerning the associations between single foods or nutrients during pregnancy and preterm birth incidence [22][23][24][25][26] . Other studies looking at dietary patterns of foods in combination during pregnancy have allowed for the interactive effect between nutrients and timing of deliveries to be studied 27,28 .…”