“…A third reason is that only few studies have controlled the association for confounding variables such as parity, gestational age (GA), socio-economic status, age, morbidity and anthropometry of the mother. The findings in most studies, however, suggest that the contribution of maternal stress to LBW, either directly or mediated through health-risk behaviours, such as cigarette smoking, alcohol intake (Pagel et al, 1990;Pritchard & Teo, 1994;Copper et al, 1996;Nordentoft et al, 1996;Jacobsen et al, 1997;Paarlberg et al, 1999), and probably coffee intake, should be considered seriously (Aarst & Vingerhoets, 1993;Hedegaard et al, 1996). Therefore, we decided to carry out a large prospective study, evaluating: (1) the associations between maternal psychological stress, distress and LBW, prematurity, and IUGR; (2) the interactions between maternal stress, distress and smoking, alcohol and coffee intake; (3) the prevalences of stress and distress in pregnancy.…”