{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T02:04:30Z","timestamp":1791079470210,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,5,29]],"date-time":"2014-05-29T00:00:00Z","timestamp":1401321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Institutes of Health and National Institute of Child Health and Human Development","award":["R01HD038856"],"award-info":[{"award-number":["R01HD038856"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study examined whether prenatal perceived stress levels during pregnancy were associated with preterm labor or preterm birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Perceived stress levels were measured at 16 weeks\u2019 gestation or less and between 20 and 24 weeks\u2019 gestation in a sample of 1069 low\u2010income pregnant women attending Temple University prenatal care clinics. Scores were averaged to create a single measure of prenatal stress. <jats:italic>Preterm birth<\/jats:italic> was defined as the occurrence of a spontaneous birth prior to 37 weeks\u2019 gestation. <jats:italic>Preterm labor<\/jats:italic> was defined as the occurrence of regular contractions between 20 and 37 weeks' gestation that were associated with changes in the cervix.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Independent of potential confounding factors, prenatal perceived stress was not associated with preterm labor (odds ratio [OR], 1.10; 95% confidence interval [CI], 0.69\u20101.78; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.66); however, prenatal stress trended toward an association with preterm birth (OR, 1.49; 95% CI, 1.00\u20102.23; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.05). The strongest predictor of preterm labor was a history of preterm labor in a prior pregnancy. Women with a history of preterm labor were 2 times more likely to experience preterm labor in the current pregnancy than women who did not have a preterm labor history (OR, 2.16; 95% CI, 1.05\u20104.41; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04). Historical risk factors for preterm birth, such as African American race, a history of abortion, or a history of preterm birth, were not related to preterm labor. The strongest predictor of preterm birth was having a history of preterm birth in a prior pregnancy (OR, 2.55; 95% CI, 1.54\u20104.24; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Prenatal perceived stress levels may be a risk factor for preterm birth independent of preterm labor; however, prenatal stress was not associated with preterm labor. Risk factors for preterm labor may be different from those of preterm birth.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.12088","type":"journal-article","created":{"date-parts":[[2014,5,29]],"date-time":"2014-05-29T16:28:03Z","timestamp":1401380883000},"page":"374-379","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Role of Perceived Stress in the Occurrence of Preterm Labor and Preterm Birth Among Urban Women"],"prefix":"10.1111","volume":"59","author":[{"given":"Laura","family":"Seravalli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freda","family":"Patterson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah B.","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-3753"},{"key":"e_1_2_6_3_1","first-page":"1","article-title":"Births: final data for 2009","volume":"60","author":"Martin JA","year":"2011","journal-title":"Natl Vital Stat Rep."},{"key":"e_1_2_6_4_1","first-page":"56","article-title":"Births: final data for 2005","volume":"2007","author":"Martin JA","journal-title":"Natl Vital Stat Rep."},{"key":"e_1_2_6_5_1","article-title":"Births: preliminary data for 2009","volume":"59","author":"Hamilton BE","year":"2010","journal-title":"Natl Vital Stat Rep."},{"key":"e_1_2_6_6_1","volume-title":"Infant mortality statistics from the 2005 period linked birth\/infant death data set","author":"Mathews T","year":"2008"},{"key":"e_1_2_6_7_1","volume-title":"Pocket Companion to Obstetrics Normal and Problem Pregnancies","author":"Gabbe SG","year":"1999"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(03)00395-8"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2012.01409.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2009.1602"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2008.00278.x"},{"key":"e_1_2_6_12_1","volume-title":"Preterm Birth: Causes, Prevention and Management","author":"Bragonier J","year":"1984"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.11.1.32"},{"key":"e_1_2_6_14_1","first-page":"2","article-title":"Risk of spontaneous preterm birth in relation to maternal depressive, anxiety, and stress symptoms","volume":"58","author":"Sanchez SE","year":"2013","journal-title":"J Reprod Med."},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70042-X"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.307.6898.234"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JNR.0000347586.08328.d6"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2010.1955"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2010.489162"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443611003802305"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.2307\/2136404"},{"key":"e_1_2_6_22_1","volume-title":"Preterm Birth: Causes, Consequences and Prevention","author":"Butler AS","year":"2006"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp061"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/JPN.0b013e31824473b9"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.3109\/01674829609025669"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(93)90016-C"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884217503257484"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/der390"}],"container-title":["Journal of Midwifery &amp; 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