Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

Assessing the Stress/Preterm-Low Birthweight Relationship

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Project Number: R40 MC 00305-03
Grantee: University of California, Berkeley
Department/Center: School of Public Health
Project Date: 09/01/2002

Final Report

Assessing the Stress/Preterm-Low Birthweight Relationship Final Report (PDF) Exit Disclaimer

Principal Investigator

Sylvia Guendelman, Ph.D.
140 Warren Hall, #7360
Berkeley, CA  94720-7630
Phone: (510) 642-2848


  • Women/Maternal
  • Prenatal
  • Perinatal/Infancy (0-12 months)


Strenuous working conditions and occupational fatigue in pregnancy have been associated with pre-term delivery (PTD) and low birthweight (LBW) among working women. Associations have also been reported between adverse pregnancy outcomes and objective or perceived stressful life events, anxiety, depression and low levels of social support. While recent studies suggest that the effects of stress on preterm deliveries may be mediated by increases in placental secretion of corticotropin-releasing hormone (CRH), no studies have looked at this relationship among working women specifically. This study offers the unique opportunity to examine race/ethnicity, socioeconomic status (SES) and CRH levels. Building on the infrastructure of a study conducted by the California Department of Health Services (DHS) in San Diego County, this study will use a nested case control design to test the extent to which occupational stressors vary by race/ethnicity or SES and how stressors (including racial discrimination) impact risk of PTD and/or LBW. It will further identify the role of CRH in mediating this effect, will weigh the contribution of antenatal leave in mediating birth outcomes, and will profile women with available antenatal leave. Data will be collected on 535 cases (LBW and/or PTD) and 535 controls who participated in the aforementioned DHS study. The DHS will make available maternal serum samples collected at 15-19 weeks gestation from which to measure CRH levels. Occupational and sociodemographic data will be available from an Environmental Health Questionnaire administered in the hospital postpartum. Eligible participants will be interviewed over the telephone within 1-5 months post delivery to query about work characteristics and antenatal leave, occupational and family/lifestyle related stressors, perceived racial discrimination and sociodemographics and to verify medical problems and birth outcome information from birth certificates. By investigating the relationships between stress during pregnancy, placental CRH and antenatal leave, this study will help identify the risks and protective factors that contribute to pregnancy outcomes among working women.


Listed is descending order by year published.

Guendelman S, Kosa JL, Pearl M, Graham S, Goodman J, Kharrazi M. Juggling work and breastfeeding: effects of maternity leave and occupational characteristics. Pediatrics. 2009 Jan;123(1):e38-46.

Guendelman S, Pearl M, Graham S, Hubbard A, Hosang N, Kharrazi M. Maternity leave in the ninth month of pregnancy and birth outcomes among working women. Womens Health Issues. 2009 Jan-Feb;19(1):30-7.

Guendelman S, Kosa JL, Pearl M, Graham S, Kharrazi M. Exploring the relationship of second-trimester corticotropin releasing hormone, chronic stress and preterm delivery. J Matern Fetal Neonatal Med. 2008 Nov;21(11):788-95.

Guendelman S, Pearl M, Graham S, Angula V, Kharrazi M. Utilization of pay-in antenatal leave among working women in Southern California. Matern Child Health J. 2006 Jan;10(1):63-73.


Preterm, Low Birthweight, Pregnancy, Perinatal, Stress, Health Disparities

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