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Maternal Stress and Pregnancy Outcomes in a Prenatal Clinic Population¹

Cecile H. Edwards², O. Jackson Cole^*, Ura Jean Oyemade^**, Enid M. Knight, Allan A. Johnson, Ouida E. Westney^**, Haziel Laryea^*, William West^*, Sidney Jones and Lennox S. Westney

The Graduate School of Arts and Sciences ^* Nutrition Program Project; Department of Nutritional Sciences, College of Allied Health Sciences ^** Department of Human Development, School of Education Department of Obstetrics and Gynecology ^* Department of Pharmacology, College of Medicine, Howard University District of Columbia General Hospital and Howard University Hospital, Washington, D.C. 20059

A two-fold decrease in the incidence of infant low birth weight, from 20.6% to 8.3%, occurred in African American women enrolled from 1985 to 1988 in this interdisciplinary research project conducted in an urban prenatal clinic. Nutritional, biochemical, medical, psychosocial, lifestyle, and environmental data were collected by trained African American interviewers. Several instruments were administered to the mother to specify the stress construct and assess body image, the social support network, and other psychosocial variables. The reduction in the incidence of low birth weight in an urban African American low income population admitted to the Howard University Hospital is attributed to the mediation of maternal stress by project personnel, in effect, providing an additional support system through the caring, sensitive environment provided by the project clinical staff, who met the women at each of their clinic-scheduled appointments. Women with a positive self attitude and higher self esteem were more likely to be delivered infants at term; the number of persons in the mother's social support network was directly correlated with her infant's gestational age. Maternal serum concentrations of the antioxidant vitamins, vitamin E and ascorbic acid, and the free radical scavenger, uric acid, were significantly correlated with serum folate and blood urea nitrogen. An hypothesis of low birth weight is presented.

KEY WORDS: • Stress during pregnancy • infant low birth weight • psychosocial factors • social support

¹ The investigations reported in this paper were made as part of the program project "Nutrition, Other Factors and the Outcome of Pregnancy," supported by the National Institute of Child Health and Human Development, National Institutes of Health, through a grant in 1985 to the Department of Human Nutrition and Food, School of Human Ecology, Howard University. Guest Editor for this supplement volume to The Journal of Nutrition was Cecile H. Edwards, Department of Nutritional Sciences, College of Allied Health Sciences, Howard University, Washington, D.C. 20059. Tapes of the data are available at cost by sending a written request to the Guest Editor at the above address. Supported by Grant 3 PO1 HD17104-05, ENG, NICHD, NIH.

² To whom reprint requests should be addressed: Department of Nutritional Sciences, College of Allied Health Sciences, Howard University, Washington, D.C. 20059.