Relationship of socioeconomic status, psychosocial factors, and food insecurity with preterm labor: A longitudinal study

Abstract

Background: Premature birth is the main cause of neonatal mortality and long-term complications, which imposes heavy financial and psychological burdens on the family and society; therefore, it is important to recognize the factors affecting it. Objective: The aim of this study was to determine the relationship between socioeconomic status, psychosocial factors, and food insecurity with preterm delivery. Materials and Methods: This longitudinal study was conducted on 674 pregnant women at 24-28 wk of gestation who met the inclusion criteria. The subjects were selected using cluster sampling. The pregnant women filled out total questionnaires of study and they followed up until delivery and the data about the newborn was collected after delivery. The data collection tools included questionnaires for evaluating socioeconomic status, psychosocial factors, and food insecurity. Results: The prevalence of preterm delivery was 7.7%, and socioeconomic factors were not associated with preterm labor. Among the intermediary factors, social health, food insecurity, stress, and prenatal care had a significant relationship with preterm labor. The prevalence rates of preterm delivery in cases with food insecurity, stress, and inadequate prenatal care were 2, 9.1 and 13.2 times higher than those who had food security, did not experience stress, and received adequate care during pregnancy. Conclusion: Preterm labor is a relatively common problem in which intermediary social determinants of health can play an important role. Considering the limited studies on this issue, the results of this study can lay the foundation for future studies.

Household food insecurity associated with gestacional and neonatal outcomes: a systematic review

“…Regarding the study design, most of the studies used a cross-sectional design (n = 20; 54%), followed by a longitudinal design (n = 10; 27%), a longitudinal design with intervention or clinical trials (n = 4; 10.8%), or a case-control design (n = 3; 8.2%). Among the publications analysed, 30 articles (81%) evaluated outcomes associated with FI exclusively during pregnancy, and seven studies (19%) evaluated the relationship between FI and outcomes among newborns [13,[24][25][26][27][28][29]. Table S1 also shows the methodologies used to assess FI in the studies.…”

“…Regarding the association of FI and neonatal outcomes, other surveys investigated low birth weight (LBW) [28], prematurity [27], hearing disorders [26] and neonatal abstinence syndrome [29].…”

“…The remaining 30 sought to investigate the relationship between FI and outcomes in pregnant women, highlighting the role of stress, anxiety, depression disorders and poor quality of diet as major factors arising from, or at least closely related to, FI. These findings are particularly worrying, as they increase physical and psychosocial vulnerability in the gestational and neonatal periods [38], including the risk of mortality [24], prematurity [27], and neonatal health problems [13,26,29], among others.…”

Explaining breastfeeding experiences and assessing factors affecting breastfeeding self-efficacy in mothers of premature infants: a mixed method study protocol

“…The economic status will be assessed as poor, average, and good by having less than 3 items, 4 to 6 items, and more than 7 items, respectively. The validity of the researcher-made socioeconomic questionnaire have been evaluated in Dolatian et al study through content validity, and its reliability have been assessed using internal consistency, Cronbach's alpha (0.876), and retest (0.916) [23].…”

“…In each section related to anxiety, depression and stress, a score of 1-7 indicated a mild level, a score of 8-14 indicated a moderate level, and a score of 15-21 indicated a severe level of anxiety, depression and stress. This questionnaire has been used in various surveys and its validity and reliability have been confirmed [23]. 5) The breastfeeding self-efficacy questionnaire: It was designed by Dennis (2003).…”