TY - JOUR
T1 - Biopsychosocial determinants of pregnancy length and fetal growth
AU - St-Laurent, Jennifer
AU - De Wals, Philippe
AU - Moutquin, Jean Marie
AU - Niyonsenga, Theophile
AU - Noiseux, Manon
AU - Czernis, Loretta
PY - 2008/5/1
Y1 - 2008/5/1
N2 - The causes and mechanisms related to preterm delivery and intrauterine growth restriction are poorly understood. Our objective was to assess the direct and indirect effects of psychosocial and biomedical factors on the duration of pregnancy and fetal growth. A self-administered questionnaire was distributed to pregnant women attending prenatal ultrasound clinics in nine hospitals in the Montérégie region in the province of Quebec, Canada, from November 1997 to May 1998. Prenatal questionnaires were linked with birth certificates. Theoretical models explaining pregnancy length and fetal growth were developed and tested, using path analysis. In order to reduce the number of variables from the questionnaire, a principal component analysis was performed, and the three most important new dimensions were retained as explanatory variables in the final models. Data were available for 1602 singleton pregnancies. The biophysical score, covering both maternal age and the pre-pregnancy body mass index, was the only variable statistically associated with pregnancy length. Smoking, obstetric history, maternal health and biophysical indices were direct predictors of fetal growth. Perceived stress, social support and self-esteem were not directly related to pregnancy outcomes, but were determinants of smoking and the above-mentioned biomedical variables. More studies are needed to identify the mechanisms by which adverse psychosocial factors are translated into adverse biological effects.
AB - The causes and mechanisms related to preterm delivery and intrauterine growth restriction are poorly understood. Our objective was to assess the direct and indirect effects of psychosocial and biomedical factors on the duration of pregnancy and fetal growth. A self-administered questionnaire was distributed to pregnant women attending prenatal ultrasound clinics in nine hospitals in the Montérégie region in the province of Quebec, Canada, from November 1997 to May 1998. Prenatal questionnaires were linked with birth certificates. Theoretical models explaining pregnancy length and fetal growth were developed and tested, using path analysis. In order to reduce the number of variables from the questionnaire, a principal component analysis was performed, and the three most important new dimensions were retained as explanatory variables in the final models. Data were available for 1602 singleton pregnancies. The biophysical score, covering both maternal age and the pre-pregnancy body mass index, was the only variable statistically associated with pregnancy length. Smoking, obstetric history, maternal health and biophysical indices were direct predictors of fetal growth. Perceived stress, social support and self-esteem were not directly related to pregnancy outcomes, but were determinants of smoking and the above-mentioned biomedical variables. More studies are needed to identify the mechanisms by which adverse psychosocial factors are translated into adverse biological effects.
KW - Fetal growth
KW - Path analysis
KW - Pregnancy length
KW - Stress
UR - http://www.scopus.com/inward/record.url?scp=42249093707&partnerID=8YFLogxK
U2 - 10.1111/j.1365-3016.2008.00926.x
DO - 10.1111/j.1365-3016.2008.00926.x
M3 - Article
C2 - 18426519
AN - SCOPUS:42249093707
SN - 0269-5022
VL - 22
SP - 240
EP - 248
JO - Paediatric and Perinatal Epidemiology
JF - Paediatric and Perinatal Epidemiology
IS - 3
ER -