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Maternal Social Support Predicts Birth Weight and Fetal Growth in Human Pregnancy

From the Department of Epidemiology and Public Health, University College London (P.J.F.), London, United Kingdom; Department of Psychology, University of California, Los Angeles (C.D.-S.), Los Angeles, CA; Department of Psychiatry, University of California, Irvine (C.A.S.), Irvine, CA; and Department of Behavioral Science, University of Kentucky (P.D.W.), Lexington, KY.

Address reprint requests to: Pamela Feldman, PhD, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.

OBJECTIVE: Low birth weight is a primary cause of infant mortality and morbidity. Results of previous studies suggest that social support may be related to higher birth weight through fetal growth processes, although the findings have been inconsistent. The purpose of this investigation was to test a model of the association between a latent prenatal social support factor and fetal growth while taking into account relations between sociodemographic and obstetric risk factors and birth weight.

METHOD: A prospective study was conducted among 247 women with a singleton, intrauterine pregnancy receiving care in two university-affiliated prenatal clinics. Measures of support included support from family, support from the baby’s father, and general functional support. Sociodemographic characteristics were also assessed. Birth outcome and obstetric risk information were abstracted from patients’ medical charts after delivery.

RESULTS: Structural equation modeling analyses showed that a latent social support factor significantly predicted fetal growth (birth weight adjusted for length of gestation) with infant sex, obstetric risk, and ethnicity in the model. Marital status and education were indirectly related to fetal growth through social support. The final model with social support and other variables accounted for 31% of the variance in fetal growth.

CONCLUSIONS: These findings suggest that prenatal social support is associated with infant birth weight through processes involving fetal growth rather than those involving timing of delivery. Biological and behavioral factors may contribute to the association between support and fetal growth, although these mechanisms need to be further explored. These results pave the way for additional research on fetal growth mechanisms and provide a basis for support intervention research.

Key Words: social support, • pregnancy • birth weight, • fetal growth.

Abbreviations: ACTH = adrenocorticotropin-releasing hormone; CFI = comparative fit index; IUGR = intrauterine growth restriction; SEM = structural equation modeling; SGA = small for gestational age.

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