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Maternal Stressors and Social Support as Risks for Delivering Babies with Structural Birth Defects
Author(s) -
Carmichael Suzan L.,
Ma Chen,
Tinker Sarah,
Rasmussen Sonia A.,
Shaw Gary M.
Publication year - 2014
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12123
Subject(s) - medicine , odds ratio , confidence interval , social support , body mass index , demography , logistic regression , stressor , population , social stress , pediatrics , environmental health , psychiatry , psychology , sociology , psychotherapist
Background We examined the association of maternal stressful life events and social support with risks of birth defects using N ational B irth D efects P revention S tudy data, a population‐based case–control study. Methods We examined seven stressful life events and three social support questions applicable to the periconceptional period, among mothers of 552 cases with neural tube defects ( NTDs ), 413 cleft palate ( CP ), 797 cleft lip ± cleft palate ( CLP ), 189 d‐transposition of the great arteries ( dTGA ), 311 tetralogy of Fallot ( TOF ), and 2974 non‐malformed controls. A stressful life events index equalled the sum of ‘yes’ responses to the seven questions. Social support questions were also summed to form an index. Data were analyzed using logistic regression to estimate odds ratios ( OR ) and 95% confidence intervals ( CI ), adjusted for maternal race‐ethnicity, age, education, body mass index, smoking, drinking, and intake of vitamin supplements. Results Associations with the stress index tended to be higher with higher scores, but few 95% CIs excluded one. A four‐point increase in the index was moderately associated with NTDs ( OR 1.5, [95% CI 1.1, 2.0]) and CLP ( OR 1.3, [95% CI 1.0, 1.7]). The social support index tended to be associated with reduced risk but most 95% CIs included one, with the exception of dTGA ( OR for a score of 3 vs 0 was 0.5 [95% CI 0.3, 0.8]). Conclusions Maternal periconceptional stressful life events, social support, and the two factors in combination were at most modestly, if at all, associated with risks of the studied birth defects.