{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T20:02:30Z","timestamp":1785009750307,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,4,4]],"date-time":"2014-04-04T00:00:00Z","timestamp":1396569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R03 DE020112"],"award-info":[{"award-number":["R03 DE020112"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["6U01-DD-000489"],"award-info":[{"award-number":["6U01-DD-000489"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["1U01-DD-0006982"],"award-info":[{"award-number":["1U01-DD-0006982"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2014,7]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>We examined the association of maternal stressful life events and social support with risks of birth defects using N<\/jats:styled-content>ational B<\/jats:styled-content>irth D<\/jats:styled-content>efects P<\/jats:styled-content>revention S<\/jats:styled-content>tudy data, a population\u2010based case\u2013control study.<\/jats:p><\/jats:sec>Methods<\/jats:title>We examined seven stressful life events and three social support questions applicable to the periconceptional period, among mothers of 552 cases with neural tube defects (NTDs<\/jats:styled-content>), 413 cleft palate (CP<\/jats:styled-content>), 797 cleft lip\u2009\u00b1\u2009cleft palate (CLP<\/jats:styled-content>), 189 d\u2010transposition of the great arteries (dTGA<\/jats:styled-content>), 311 tetralogy of Fallot (TOF<\/jats:styled-content>), and 2974 non\u2010malformed controls. A stressful life events index equalled the sum of \u2018yes\u2019 responses to the seven questions. Social support questions were also summed to form an index. Data were analyzed using logistic regression to estimate odds ratios (OR<\/jats:styled-content>) and 95% confidence intervals (CI<\/jats:styled-content>), adjusted for maternal race\u2010ethnicity, age, education, body mass index, smoking, drinking, and intake of vitamin supplements.<\/jats:p><\/jats:sec>Results<\/jats:title>Associations with the stress index tended to be higher with higher scores, but few 95% CIs<\/jats:styled-content> excluded one. A four\u2010point increase in the index was moderately associated with NTDs<\/jats:styled-content> (OR<\/jats:styled-content> 1.5, [95% CI<\/jats:styled-content> 1.1, 2.0]) and CLP<\/jats:styled-content> (OR<\/jats:styled-content> 1.3, [95% CI<\/jats:styled-content> 1.0, 1.7]). The social support index tended to be associated with reduced risk but most 95% CIs<\/jats:styled-content> included one, with the exception of dTGA<\/jats:styled-content> (OR<\/jats:styled-content> for a score of 3 vs 0 was 0.5 [95% CI<\/jats:styled-content> 0.3, 0.8]).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Maternal periconceptional stressful life events, social support, and the two factors in combination were at most modestly, if at all, associated with risks of the studied birth defects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12123","type":"journal-article","created":{"date-parts":[[2014,4,4]],"date-time":"2014-04-04T04:23:04Z","timestamp":1396585384000},"page":"338-344","source":"Crossref","is-referenced-by-count":33,"title":["Maternal Stressors and Social Support as Risks for Delivering Babies with Structural Birth Defects"],"prefix":"10.1111","volume":"28","author":[{"given":"Suzan L.","family":"Carmichael","sequence":"first","affiliation":[{"name":"Department of Pediatrics Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Tinker","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia A.","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary M.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"National Birth Defects Prevention Study","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000259986.85239.87"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-196404000-00009"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9969(94)00146-3"},{"key":"e_1_2_7_5_1","first-page":"145","article-title":"A recent aetiological study on facial clefting in Hungary","volume":"27","author":"Czeizel A","year":"1986","journal-title":"Acta Paediatrica 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