{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:51:03Z","timestamp":1791532263202,"version":"4.3.4"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Womens Ment Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Maternal anxiety is a clinically relevant mental health concern during pregnancy and may contribute to reduced fetal growth, particularly when co-occurring with prenatal tobacco use. To examine the individual and contextual associations of maternal anxiety and prenatal tobacco use with infant birth weight using 2021\u20132023 Pregnancy Risk Assessment Monitoring System data. The analytic sample included 29,288 mothers nested within 11 states or jurisdictions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two-level linear mixed models were estimated to predict continuous infant birth weight, with a random slope for maternal anxiety to assess whether the anxiety\u2013birth weight association varied across states or jurisdictions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Prenatal tobacco use was associated with an approximately 219-gram reduction in birth weight (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001), while maternal anxiety was associated with an approximately 60-gram reduction (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001). State-level prevalence of anxiety and tobacco use did not directly predict birth weight; however, the association between maternal anxiety and birth weight varied across states or jurisdictions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings support integrated prenatal care approaches that combine maternal mental health screening, tobacco cessation support, and attention to contextual systems that may shape maternal and infant health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00737-026-01773-4","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:09:49Z","timestamp":1790402989000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prenatal anxiety, tobacco use, and infant birth weight: a multilevel analysis of PRAMS data"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4941-2112","authenticated-orcid":false,"given":"Sunghyun","family":"Chung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8620-6816","authenticated-orcid":false,"given":"Lawrence","family":"Watkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"issue":"2","key":"1773_CR3","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1038\/s41390-024-03346-6","volume":"97","author":"C Amadou","year":"2025","unstructured":"Amadou C, Ancel PY, Zeitlin J, Ribet C, Zins M, Charles MA (2025) Long-term health in individuals born preterm or with low birth weight: A cohort study. 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The Pregnancy Risk Assessment Monitoring System (PRAMS) original data collection protocol was reviewed and approved by the Institutional Review Board (IRB) of the Centers for Disease Control and Prevention (CDC) and the respective health departments&apos; IRBs of the participating jurisdictions (Delaware, Kansas, Michigan, Missouri, Montana, New Jersey, Pennsylvania, Utah, Washington, Wisconsin, and New York City). Informed consent was obtained from all participants as part of the original PRAMS data collection procedures.The present study is a secondary analysis of publicly available, fully de-identified aggregate data. Because the dataset contains no identifiable private information, this study does not constitute human subjects research under U.S. federal regulation 45 CFR 46. Therefore, this study was determined to be exempt from Texas A&amp;M University Institutional Review Board (IRB) review, as it utilizes public-use, de-identified data.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"134"}}