Infant birthweight in the US: the role of preconception stressful life events and substance use

Abstract

PURPOSE The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women’s alcohol and tobacco use before and during pregnancy, and infant birthweight. METHODS Data were from the Early Childhood Longitudinal Study-Birth Cohort (n=9,350). Data were collected in 2001. Exposure to PSLEs was defined by indications of death of a parent, spouse, or previous live born child; divorce or marital separation; or fertility problems prior to conception. Survey data determined alcohol and tobacco usage during the three months prior to and in the final three months of pregnancy. We used staged multivariable logistic regression to estimate the effects of women’s substance use and PSLEs on the risk of having a very low (<1,500 grams, VLBW) or low (1,500–2,499 grams, LBW) birthweight infant, adjusting for confounders. RESULTS Women who experienced any PSLE were more likely to give birth to VLBW infants (adjusted odds ratio [AOR]: 1.35; 95% confidence interval [CI]: 1.10–1.66) than women who did not experience any PSLE. Compared to women who never smoked, women who smoked prior to conception (AOR: 1.31; 95% CI: 1.04–1.66) or during their last trimester (AOR: 1.98; 95% CI: 1.56–2.52) were more likely to give birth to LBW infants. CONCLUSIONS PSLEs and women’s tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby. Interventions to improve birth outcomes may need to address women’s health and health behaviors in the preconception period.

Lifetime substance use as a predictor of postpartum mental health

“…For example, querying lifetime substance use may provide a more accurate assessment of typical usage patterns and associated mood and coping strategies. Furthermore, the serious consequences of substance use during a pregnancy, including placental abruption, preterm birth, fetal growth restriction (Pinto et al 2010), low birth weight (Witt et al 2016), and fetal alcohol spectrum disorder (Ornoy and Ergaz 2010), are the focus of considerable media attention and public health campaigns, which may inadvertently contribute to underreporting of substance use (Ernhart et al 1988). Indeed, Jacobson et al (1991) found that mothers underreport substance use when queried while pregnant but report greater usage when asked postnatally to provide retrospective reports of their antenatal substance use.…”

Population Attributable Fractions of Caffeine and Water Pipe on Low Birth Weight: A Population-Based Prospective Cohort Study in Iran

“…Due to many exogenous and endogenous factors, it is likely that the measured dose of caffeine did not necessarily re ect the actual concentration of metabolites in the woman`s body (27). Moreover, we are aware that the amount of caffeine in beverages is heavily determined by methods of beverage preparation; therefore, non-differential misclassi cation bias for the measured dose of caffeine is likely (9).…”

“…Detrimental effects of water pipe smoking on pregnancy outcomes have been reported previously (2,5,8). LBW is also linked to the excess intake of caffeine; whereas its adverse effect on pregnancy outcome has not been fully worked out (9)(10)(11). From the epidemiological point of view, the Population Attributable Fraction (PAF), de ned as the fraction of all cases of a particular health condition that is attributable to a speci c exposure, is an epidemiologic measure widely used to assess the public health impact of various exposures (12).…”

Ontogeny and programming of the fetal temporal cortical endocannabinoid system by moderate maternal nutrient reduction in baboons ( Papio spp.)

“…Maternal stress in the peri‐conceptual period is linked to infant low birth weight (Witt et al. ). CB1R expression in the hypothalamus was not affected in a rat model of MNR (Matias et al.…”