Effects on birth weight of smoking, alcohol, caffeine, socioeconomic factors, and psychosocial stress.
Journal: 1989/June - BMJ (Clinical research ed.)
ISSN: 0959-8138
PUBMED: 2496859
Abstract:
OBJECTIVE
To investigate the effects of smoking, alcohol, and caffeine consumption and socio-economic factors and psychosocial stress on birth weight.
METHODS
Prospective population study.
METHODS
District general hospital in inner London.
METHODS
A consecutive series of 1860 white women booking for delivery were approached. 136 Refused and 211 failed to complete the study for other reasons (moved, abortion, subsequent refusal), leaving a sample of 1513. Women who spoke no English, booked after 24 weeks, had insulin dependent diabetes, or had a multiple pregnancy were excluded.
METHODS
Data were obtained by research interviewers at booking (general health questionnaire, modified Paykel's interview, and Eysenck personality questionnaire) and at 17, 28, and 36 weeks' gestation and from the structured antenatal and obstetric record. Variables assessed included smoking, alcohol consumption, caffeine consumption, and over 40 indicators of socio-economic state and psychosocial stress, including social class, tenure of accommodations, education, employment, income, anxiety and depression, stressful life events, social stress, social support, personality, and attitudes to pregnancy. Birth weight was corrected for gestation and adjusted for maternal height, parity, and baby's sex.
RESULTS
Smoking was the most important single factor (5% reduction in corrected birth weight). Passive smoking was not significant (0.5% reduction). After smoking was controlled for, alcohol had an effect only in smokers and the effects of caffeine became non-significant. Only four of the socioeconomic and stress factors significantly reduced birth weight and these effects became non-significant after smoking was controlled for.
CONCLUSIONS
Social and psychological factors have little or no direct effect on birth weight corrected for gestational age (fetal growth), and the main environmental cause of its variation in this population was smoking.
Relations:
Content
Citations
(72)
References
(24)
Conditions
(1)
Drugs
(3)
Chemicals
(2)
Organisms
(1)
Processes
(3)
Affiliates
(1)
Similar articles
Articles by the same authors
Discussion board
BMJ 298(6676): 795-801

Effects on birth weight of smoking, alcohol, caffeine, socioeconomic factors, and psychosocial stress.

Abstract

OBJECTIVE--To investigate the effects of smoking, alcohol, and caffeine consumption and socio-economic factors and psychosocial stress on birth weight. DESIGN--Prospective population study. SETTING--District general hospital in inner London. PARTICIPANTS--A consecutive series of 1860 white women booking for delivery were approached. 136 Refused and 211 failed to complete the study for other reasons (moved, abortion, subsequent refusal), leaving a sample of 1513. Women who spoke no English, booked after 24 weeks, had insulin dependent diabetes, or had a multiple pregnancy were excluded. MEASUREMENTS--Data were obtained by research interviewers at booking (general health questionnaire, modified Paykel's interview, and Eysenck personality questionnaire) and at 17, 28, and 36 weeks' gestation and from the structured antenatal and obstetric record. Variables assessed included smoking, alcohol consumption, caffeine consumption, and over 40 indicators of socio-economic state and psychosocial stress, including social class, tenure of accommodations, education, employment, income, anxiety and depression, stressful life events, social stress, social support, personality, and attitudes to pregnancy. Birth weight was corrected for gestation and adjusted for maternal height, parity, and baby's sex. MAIN RESULTS--Smoking was the most important single factor (5% reduction in corrected birth weight). Passive smoking was not significant (0.5% reduction). After smoking was controlled for, alcohol had an effect only in smokers and the effects of caffeine became non-significant. Only four of the socioeconomic and stress factors significantly reduced birth weight and these effects became non-significant after smoking was controlled for. CONCLUSIONS--Social and psychological factors have little or no direct effect on birth weight corrected for gestational age (fetal growth), and the main environmental cause of its variation in this population was smoking.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Williams RL, Chen PM. Identifying the sources of the recent decline in perinatal mortality rates in California. N Engl J Med. 1982 Jan 28;306(4):207–214. [PubMed] [Google Scholar]
  • Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med. 1979 Feb;9(1):139–145. [PubMed] [Google Scholar]
  • Paykel ES, Myers JK, Dienelt MN, Klerman GL, Lindenthal JJ, Pepper MP. Life events and depression. A controlled study. Arch Gen Psychiatry. 1969 Dec;21(6):753–760. [PubMed] [Google Scholar]
  • Keen DV, Pearse RG. Birthweight between 14 and 42 weeks' gestation. Arch Dis Child. 1985 May;60(5):440–446.[PMC free article] [PubMed] [Google Scholar]
  • Gardner MJ, Altman DG. Confidence intervals rather than P values: estimation rather than hypothesis testing. Br Med J (Clin Res Ed) 1986 Mar 15;292(6522):746–750.[PMC free article] [PubMed] [Google Scholar]
  • Carr-Hill R, Campbell DM, Hall MH, Meredith A. Is birth weight determined genetically? Br Med J (Clin Res Ed) 1987 Sep 19;295(6600):687–689.[PMC free article] [PubMed] [Google Scholar]
  • Rush D, Cassano P. Relationship of cigarette smoking and social class to birth weight and perinatal mortality among all births in Britain, 5-11 April 1970. J Epidemiol Community Health. 1983 Dec;37(4):249–255.[PMC free article] [PubMed] [Google Scholar]
  • Meredith HV. Relation between tobacco smoking of pregnant women and body size of their progeny: a compilation and synthesis of published studies. Hum Biol. 1975 Dec;47(4):451–472. [PubMed] [Google Scholar]
  • Rubin DH, Krasilnikoff PA, Leventhal JM, Weile B, Berget A. Effect of passive smoking on birth-weight. Lancet. 1986 Aug 23;2(8504):415–417. [PubMed] [Google Scholar]
  • Trichopoulos D. Passive smoking, birthweight, and oestrogens. Lancet. 1986 Sep 27;2(8509):743–743. [PubMed] [Google Scholar]
  • Lee PN. Misclassification as a factor in passive smoking risk. Lancet. 1986 Oct 11;2(8511):867–867. [PubMed] [Google Scholar]
  • Martin TR, Bracken MB. Association of low birth weight with passive smoke exposure in pregnancy. Am J Epidemiol. 1986 Oct;124(4):633–642. [PubMed] [Google Scholar]
  • Barrison IG, Waterson EJ, Murray-Lyon IM. Adverse effects of alcohol in pregnancy. Br J Addict. 1985 Mar;80(1):11–22. [PubMed] [Google Scholar]
  • Wright JT, Waterson EJ, Barrison IG, Toplis PJ, Lewis IG, Gordon MG, MacRae KD, Morris NF, Murray-Lyon IM. Alcohol consumption, pregnancy, and low birthweight. Lancet. 1983 Mar 26;1(8326 Pt 1):663–665. [PubMed] [Google Scholar]
  • Kline J, Stein Z, Hutzler M. Cigarettes, alcohol and marijuana: varying associations with birthweight. Int J Epidemiol. 1987 Mar;16(1):44–51. [PubMed] [Google Scholar]
  • Sulaiman ND, Florey CD, Taylor DJ, Ogston SA. Alcohol consumption in Dundee primigravidas and its effects on outcome of pregnancy. Br Med J (Clin Res Ed) 1988 May 28;296(6635):1500–1503.[PMC free article] [PubMed] [Google Scholar]
  • Watkinson B, Fried PA. Maternal caffeine use before, during and after pregnancy and effects upon offspring. Neurobehav Toxicol Teratol. 1985 Jan-Feb;7(1):9–17. [PubMed] [Google Scholar]
  • Linn S, Schoenbaum SC, Monson RR, Rosner B, Stubblefield PG, Ryan KJ. No association between coffee consumption and adverse outcomes of pregnancy. N Engl J Med. 1982 Jan 21;306(3):141–145. [PubMed] [Google Scholar]
  • Picone TA, Allen LH, Olsen PN, Ferris ME. Pregnancy outcome in North American women. II. Effects of diet, cigarette smoking, stress, and weight gain on placentas, and on neonatal physical and behavioral characteristics. Am J Clin Nutr. 1982 Dec;36(6):1214–1224. [PubMed] [Google Scholar]
  • Chalmers B. Psychosocial factors and obstetric complications. Psychol Med. 1983 May;13(2):333–339. [PubMed] [Google Scholar]
  • Norbeck JS, Tilden VP. Life stress, social support, and emotional disequilibrium in complications of pregnancy: a prospective, multivariate study. J Health Soc Behav. 1983 Mar;24(1):30–46. [PubMed] [Google Scholar]
  • Stein A, Campbell EA, Day A, McPherson K, Cooper PJ. Social adversity, low birth weight, and preterm delivery. Br Med J (Clin Res Ed) 1987 Aug 1;295(6593):291–293.[PMC free article] [PubMed] [Google Scholar]
  • Newton RW, Hunt LP. Psychosocial stress in pregnancy and its relation to low birth weight. Br Med J (Clin Res Ed) 1984 Apr 21;288(6425):1191–1194.[PMC free article] [PubMed] [Google Scholar]
  • Newton RW, Webster PA, Binu PS, Maskrey N, Phillips AB. Psychosocial stress in pregnancy and its relation to the onset of premature labour. Br Med J. 1979 Aug 18;2(6187):411–413.[PMC free article] [PubMed] [Google Scholar]
Department of Child Health, St George's Hospital Medical School, London.
Department of Child Health, St George's Hospital Medical School, London.
Abstract
OBJECTIVE--To investigate the effects of smoking, alcohol, and caffeine consumption and socio-economic factors and psychosocial stress on birth weight. DESIGN--Prospective population study. SETTING--District general hospital in inner London. PARTICIPANTS--A consecutive series of 1860 white women booking for delivery were approached. 136 Refused and 211 failed to complete the study for other reasons (moved, abortion, subsequent refusal), leaving a sample of 1513. Women who spoke no English, booked after 24 weeks, had insulin dependent diabetes, or had a multiple pregnancy were excluded. MEASUREMENTS--Data were obtained by research interviewers at booking (general health questionnaire, modified Paykel's interview, and Eysenck personality questionnaire) and at 17, 28, and 36 weeks' gestation and from the structured antenatal and obstetric record. Variables assessed included smoking, alcohol consumption, caffeine consumption, and over 40 indicators of socio-economic state and psychosocial stress, including social class, tenure of accommodations, education, employment, income, anxiety and depression, stressful life events, social stress, social support, personality, and attitudes to pregnancy. Birth weight was corrected for gestation and adjusted for maternal height, parity, and baby's sex. MAIN RESULTS--Smoking was the most important single factor (5% reduction in corrected birth weight). Passive smoking was not significant (0.5% reduction). After smoking was controlled for, alcohol had an effect only in smokers and the effects of caffeine became non-significant. Only four of the socioeconomic and stress factors significantly reduced birth weight and these effects became non-significant after smoking was controlled for. CONCLUSIONS--Social and psychological factors have little or no direct effect on birth weight corrected for gestational age (fetal growth), and the main environmental cause of its variation in this population was smoking.
Collaboration tool especially designed for Life Science professionals.Drag-and-drop any entity to your messages.