Maternal Weathering and Risk of Preterm Delivery

Abstract

Objectives. We compared the association between advancing maternal age and risk of preterm delivery across 4 groups (Black smokers, Black nonsmokers, White smokers, White nonsmokers) and within the context of neighborhood deprivation levels. Methods. We obtained data from linked census and birth records for singletons (n = 182 938) delivered by women aged 20 to 39 years in Philadelphia, Pennsylvania; Baltimore, Maryland; 16 Michigan cities; 3 Maryland counties; and 2 North Carolina counties. Results from area-specific multilevel logistic regression models were combined to obtain pooled estimates of relations between maternal age and risk of preterm delivery. We repeated the models after categorizing women by neighborhood deprivation level (low, medium, and high). Results. Among multiparous women, there was a significant age-related increase in preterm delivery in 3 of the 4 groups. The adjusted odds ratio per 5-year age increase was 1.31 in Black smokers, 1.11 in Black nonsmokers, and 1.16 in White smokers. In each group, the odds ratio increased as neighborhood deprivation increased. Conclusions. These results support the “weathering” hypothesis, suggesting that Black women, women with high-risk behaviors, and women living in high-deprivation neighborhoods may develop “accelerated aging” that increases preterm delivery risk.

Allostatic Load in Women with a History of Low Birth Weight Infants: The National Health and Nutrition Examination Survey

“…Prior studies using subjective assessments of stress have found associations between stress and anxiety during pregnancy and perinatal outcomes. [25][26][27][28] Our findings using AL score as an objective measure of chronic stress are consistent with those findings. AL conceptually captures the ''cost'' of adaptation to stressors.…”

Does higher income inequality adversely influence infant mortality rates? Reconciling descriptive patterns and recent research findings

“…In turn, these effects on the ambient social and economic aspects of the environment create both materially and psychologically stressful conditions, which lead to adverse physiological processes and damaging health behaviors (Phelan et al, 2004;Link and Phelan, 1995;McEwen and Gianaros, 2010;McEwen et al, 1999;Pham-Kanter, 2009). Because such conditions and their associated physiological and behavioral manifestations have been found through markers such as low birth weight to influence fetal and infant well-being, including infant mortality, it was reasonable to assess whether income inequality was also associated with IMR (Geronimus, 1992;Geronimus et al, 2006;Holzman et al, 2009;Messer and Kaufman, 2010).…”

Childbearing Postponement and Child Well-being: A Complex and Varied Relationship?

“…They are also reported to have higher allostatic loads, which previous research has established as a marker of poverty-related health conditions ) 2 at any age, but particularly from age 35 onward (Chyu and Upchurch 2011;Geronimus et al 2006). These conditions include an elevated risk of developing health conditions, such as hypertension, which can lead to complications that compromise fetal development (Geronimus 1996;Rich-Edwards et al 2003); indeed, evidence exists that ethnic gaps in neonatal mortality, preterm birth, and low birth weight (LBW)-frequently used as outcome variables in these studies-increase with maternal age at birth (Geronimus 1996;Holzman et al 2009;Rauh et al 2001;Reichman and Pagnini 1997;Rich-Edwards et al 2003;Shmueli and Cullen 1999). Consistent with the hypothesis that social inequality is linked to differential health trajectories, a number of studies have demonstrated that African American mothers exposed (as children and/or adults) to poorer environments experience a more rapid increase in the rates of LBW with increasing maternal age at birth (Geronimus 1996;Loveet al 2010;Rauh et al 2001).…”