Warning message

This content is filtered. APPPAH membership is required for full access to journal articles.
-A +A
Publication Date: 
December, 1991
Page Count: 
Starting Page: 

Scores on six psychosocial questionnaires were compared to the risk of delivering an IUGR infant. In the second trimester, scales for stress, anxiety, social support, mastery, self esteem, and depression were prospectively administered to 1500 indigent women. In univariate analyses, significant relationships were found between IUGR and a poor score for mastery, stress, anxiety and self-esteem. The results were additive in that the more poor the scores, the higher the rate of IUGR. In a series of regression analyses controlling for height, weight, smoking, alcohol use, and the birth of a previous low birthweight infant, poor scores on 3 of the scales and an overall poor score remained significantly associated with IUGR, with odds ratios ranging from 1.68 to 2.34.


1. Norbeck JS, Tilden VP. Life Stress, Social Support, and Emotional Disequilibrium in Complications of Pregnancy: A Prospective, Multivariate Study. Journal of Health and Social Behavior 24:30-46, 1983.

2. Nuckolls KB, Cassel J, Kaplan BH. Psychosocial Assets, Life Crisis and The Prognosis of Pregnancy. American Journal of Epidemiology 95(5): 431-441, 1972.

3. Bergsjo P, Hoffman HJ, Davis RO, et al. Preliminary Results From The Collaborative Alabama and Scandinavian Study of Successive Small-For-Gestational-Age Births. Report From a Symposium in Trondheim, June 9, 1988. Acta Obstetrics Gynecology Scandinavia 68:19-25, 1989.

4. Pascoe JM, Ialongo NS, Horn WF, et al. The Reliability and Validity of the Maternal Social Support Index. Family Medicine 20:271-276, 1988.

5. Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory. Consulting Psychology Press, Palo Alto, CA, 1970.

6. Rosenberg M. Society and Adolescent Self Image. Princeton University Press, Princeton, NJ, 1965.

7. Pearlin LI, Liberman MA, et al. The stress process. Journal Health and Social Behavior 22:337-356, 1981.

8. Radloff LS. The CES-D scale: a self report depression scale for research on a general population. Applied Psychol Measurement 1:385-401, 1977.

9. Williams RL, Creasy RK, Cunningham GC. Fetal growth and perinatal viability in California. Obstetrics & Gynecology 1982;59:624-632.

10. Miller CM, Merritt TA. Fetal Growth in Humans. Chicago, Year Book Medical Publishers, 1979.

11. McDonald RL. The Role of Emotional Factors in Obstetric Complications: A Review. Psychosomatic Medicine 30:222-237, 1968.

12. Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bulletin World Health Organization 65:663-737, 1987.

13. Istvan J. Stress, Anxiety, and Birth Outcomes: A Critical Review of the Evidence. Psychological Bulletin 100:331-348, 1986.

14. Zuckerman G, Amaro H, Bauchner H, Cabral H. Depressive symptoms during pregnancy: Relationship to poor health behaviors. American Journal of Obstetrics & Gynecology 160:1107-1111, 1989.

15. McCormick MC, Brooks-Gunn J, Shorter T, et al. Factors associated with smoking in low income pregnant women: Relationship to birthweight, stressful life events, social support, health behaviors and mental distress. Journal of Clinical Epidemiology 43:441-448, 1990.

16. Divers WA, Wilkes MM, Babaknia A, et al. Amniotic fluid catecholamines and metabolites in intrauterine growth retardation. American Journal of Obstetrics & Gynecology 141:608-610, 1981.

Robert L. Goldenberg, M.D., Suzanne P. Oliver, B.A., Gary R. Cutter, M.S., Ph.D., Howard J. Hoffman, M.A., Rachel L. Copper, M.S.N., C.R.N.P., Sharon Gotlieb, Ph.D., and Richard O. Davis, M.D.

Robert L. Goldenberg, M.D., and Sharon Gotlieb, Ph.D., are with the Perinatal Epidemiology Unit, The Department of Obstetrics and Gynecology, and the School of Public Health, The University of Alabama at Birmingham. Suzanne P. Cliver, B.A., Rachel L. Copper, M.S.N., C.R.N.P., and Richard O. Davis, M.D., are with the Perinatal Epidemiology Unit, The Department of Obstetrics and Gynecology, The University of Alabama at Birmingham. Gary R. Cutter, M.S., Ph.D., is with the Division of Biostatistics and Information Systems, St Jude Children's Research Hospital, Memphis, Tennessee. Howard J. Hoffman, M.A., is with the Prevention Research Program, National Institutes of Child Health and Human Development, National Institutes of Health.

Address correspondence and reprint requests to Robert L. Goldenberg, M.D., Department of Obstetrics and Gynecology, University of Alabama at Birmingham, University Station, Birmingham, Alabama 35294.

To speak with a representative about our products and services or for technology inquiries, please call 1-720-490-5612.