This investigation will differentiate between psychological stress and physical strain (or exertion), and test their contributions to preterm delivery and low birth weight. Both factors are associated with poor perinatal outcome. However, few studies to date have focused on separating their confounding effects on low birth weight and preterm delivery while examining those of other determinants (e.g. medical complications, demographics, or health behaviors). A conceptual model has been developed based on the existing empirical literature and the previous research of the principal investigators, Hobel and Dunkel-Schetter, in which the effects of psychological stress (conceptualized as perceived chronic stress), and the effects of physical exertion (conceptualized here as physical strain in activities of daily living) on time of delivery and birthweight will be examined. In addition, biochemical, biophysical, and behavioral mechanisms hypothesized to mediate the effects of these variables on outcomes are to be tested. These issues will be addressed in a prospective and longitudinal study of 500 women, 18 years or older, recruited from public, private, and managed health-care settings. The sample will be diverse with respect to ethnicity, maternal risk conditions, and parity. Women will be entered into the study up to 20 weeks gestation. Data will be collected at time of entry into the study, on two successive occasions prior to delivery, and once postpartum by interview to assess the two major study variables (perceived chronic stress and reported physical strain). Biochemical mediators will be measured by analysis of urinary catecholamines and cortisol. Biophysical parameters to be obtained are fetal growth, fetal state, and uterine activity. In addition, substance use and social support will be assessed with interviews on these occasions to test whether they mediate the hypothesized relationships between predictors and outcomes. Outcomes will be obtained from the labor, delivery, postpartum and newborn data systems.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD029553-01
Application #
3331064
Study Section
Human Development and Aging Subcommittee 3 (HUD)
Project Start
1992-08-01
Project End
1995-07-31
Budget Start
1992-08-01
Budget End
1993-07-31
Support Year
1
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Cedars-Sinai Medical Center
Department
Type
DUNS #
075307785
City
Los Angeles
State
CA
Country
United States
Zip Code
90048
Ritz, Beate; Qiu, Jiaheng; Lee, Pei-Chen et al. (2014) Prenatal air pollution exposure and ultrasound measures of fetal growth in Los Angeles, California. Environ Res 130:7-13
Hahn-Holbrook, Jennifer; Schetter, Christine Dunkel; Arora, Chander et al. (2013) Placental Corticotropin-Releasing Hormone Mediates the Association Between Prenatal Social Support and Postpartum Depression. Clin Psychol Sci 1:253-264
Misra, Vinod K; Hobel, Calvin J; Sing, Charles F (2010) The effects of maternal weight gain patterns on term birth weight in African-American women. J Matern Fetal Neonatal Med 23:842-9
Misra, V K; Hobel, C J; Sing, C F (2009) Placental blood flow and the risk of preterm delivery. Placenta 30:619-24
Campos, Belinda; Schetter, Christine Dunkel; Abdou, Cleopatra M et al. (2008) Familialism, social support, and stress: positive implications for pregnant Latinas. Cultur Divers Ethnic Minor Psychol 14:155-62
Misra, Vinod K; Hobel, Calvin J; Sing, Charles F (2008) Ethnic heterogeneity in the longitudinal effects of placental vascular blood flow on birthweight. Am J Obstet Gynecol 198:72.e1-8
Dominguez, Tyan Parker; Schetter, Christine Dunkel; Mancuso, Roberta et al. (2005) Stress in African American pregnancies: testing the roles of various stress concepts in prediction of birth outcomes. Ann Behav Med 29:12-21
Mancuso, Roberta A; Schetter, Christine Dunkel; Rini, Christine M et al. (2004) Maternal prenatal anxiety and corticotropin-releasing hormone associated with timing of delivery. Psychosom Med 66:762-9
Herrmann, T S; Siega-Riz, A M; Hobel, C J et al. (2001) Prolonged periods without food intake during pregnancy increase risk for elevated maternal corticotropin-releasing hormone concentrations. Am J Obstet Gynecol 185:403-12
Hobel, C J; Dunkel-Schetter, C; Roesch, S C et al. (1999) Maternal plasma corticotropin-releasing hormone associated with stress at 20 weeks' gestation in pregnancies ending in preterm delivery. Am J Obstet Gynecol 180:S257-63

Showing the most recent 10 out of 11 publications