Anxiety weighs down pregnancies and births.

Anxiety weighs down pregnancies and births

Though physicians routinely monitor the medical condition of pregnant women, a new study suggests they should pay equal attention to social and psychological influences during pregnancy.

"Chronic emotional distress and anxiety during pregnancy importantly contribute to premature births and low-birthweight babies, independently of the mother's medical risks," reports psychologist Marci Lobel of the State University of New York at Stony Brook. She presented her findings in Boston last week at the annual meeting of the American Psychological Association.

Babies weighing less than 5-1/2 pounds stand a much greater chance of dying in the first few months after birth than normal-weight infants. About 7 percent of all U.S. newborns, or about 250,000 births each year, fall into the low-birthweight category.

Lobel, working with Christine Dunkel-Schetter and Susan Scrimshaw of the University of California, Los Angeles, studied 130 women aged 18 to 42 receiving prenatal care at the UCLA Medical Center. Most were Hispanic and had low incomes. The researchers monitored the women for several indicators of emotional stress, including daily feelings of anxiety, chronic sources of anxiety, and distressing events such as financial set-backs or the death of a loved one. They also checked each woman's medical records for 66 medical risk factors such as diabetes or complicators during previous pregnancies. Roughly two-thirds of the women had been pregnant before.

The team found that premature births occurred most frequently among the women who faced a combination of medical risks and emotional stress. Moreover, Lobel says, the newborn's gestational age and the mother's emotional stress predicted the low birthweights, whereas medical risks alone did not.

Emotional stress did not affect the difficulty of labor, the baby's physical condition immediately after birth, or subsequent neonatal complications, she notes. The ease of labor and the baby's health at birth did correlate, however, with the amount of social support the mother received during pregnancy, such as financial assistance and help with chores and child care.

Women who suffered most from daily anxiety proved the most likely to deliver premature and low-birthweight babies, Lobel says. "What's important seems to be how one interprets negative life events, not how many of these events occur," she asserts.

Though several previous reports have linked upsetting life events to premature birth, Lobel says none of these studies thoroughly documented anxiety during pregnancy.

"We don't want to alarm women," she adds. "Every pregnant mother experiences some emotional stress, often without effects on the baby." No evidence yet shows that reducing emotional stress during pregnancy improves birth outcomes, she points out.

Nevertheless, researchers should begin formulating and studying programs to ease the emotional burdens of particularly distressed women during pregnancy, says psychologist Elaine Blechman of the University of Colorado in Boulder.

Meanwhile, Dunkel-Schetter says, "we hope the findings will encourage physicians to weigh emotional stress, as well as medical history, when considering the possibility that a mother will deliver prematurely or have a low-birthweight infant."