Clinical assessment of pregnant women's psychosocial conditions, prematurity and birth weight

Social Support and Pregnancy

“…Others attempt to strengthen the woman's existing social network by requiring a support person (often her partner, a family member, or a friend) to be present at each home visit (e.g., Olds etaI., 1986;Villar etaI., 1993). Interventions of this type have been invoked most often for women who are socially or medically at high risk for poor pregnancy outcomes (e.g., Bryce et aI., 1991;Forde, 1993;Heins et aI., 1990;Oakley et aI., 1990;Olds et aI., 1986;Sokol et aI., 1980;Spencer et aI., 1989;Villar et aI., 1993). Studies of these interventions are often experimental or quasiexperimental and tend to evaluate the interventions in terms of improvements in labor, delivery, and infant outcomes.…”

“…Specifically, the studies that do not show results sometimes suffer from small sample sizes (e.g., Blondel, Breart, Llado, & Chartier, 1990) or insufficient statistical power to detect differences (e.g., Bryce et aI., 1991;Spencer et aI., 1989), or they employ weak manipulations (e.g., Blondel et aI., 1990). Others do not use random assignment (e.g., Forde, 1993;Larsson, Spangberg, Theorell, & Wager, 1987;Piechnik & Corbett, 1985;Sokol et aI., 1980) or have differential attrition. For example, one study reported that almost 60% of the women randomly assigned to the intervention group refused the intervention (Spencer et aI., 1989).…”

“…On the other hand, selection of truly "at-risk" subgroups may be more difficult than it seems. For instance, one researcher found that assessment of poor psychosocial conditions using a questionnaire was not sufficient to identify women most likely to benefit from additional support (Forde, 1993). His method of assessing risk, based on a "subjective and intuitive combination of all accessible clinical information" (p. 131), is probably too unwieldy or ambitious for most applications, but it points to a possible weakness in this line of research that should be corrected.…”

Modulation off birthweight through gestational age and fetal growth

“…Other authors have found no association between maternal work at pregnancy and birthweight but this may imply that working during pregnancy reflects different levels of hardship and job stress in different Petridou et al (Fenster & Coye 1990;Amine & Al-Awadi 1991;Lars, Nielsen & Nielsen 1992). There is no obvious pathophysiological process to accommodate the inverse association between birthweight and perceived stress during pregnancy but a similar association has been reported by Swedish investigators who have used an objective scale to assess stress (Forde 1993). In several studies adolescent pregnancies have been associated with low birthweight (SchoU et al 1992a;Michielutte et al 1992) but such an association was not evident among young mothers in the present data set, possibly because early motherhood in Greece is not strongly associated with being single and also is not socially marginalized.…”

The Nursing Management of Women Experiencing Preterm Labor: Clinical Guidelines and Why They Are Needed

“…Hedegaard, Henriksen, Sabroe, and Secher (1993) found that psychologic distress later in pregnancy was associated more closely with preterm delivery among a sample of women in Denmark. Forde (1993) linked prematurity and low birth weight in a Scandinavian sample to psychosocial risks such as younger age and less education.…”