{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T02:04:20Z","timestamp":1791079460798,"version":"4.1.0"},"reference-count":34,"publisher":"BMJ","issue":"6676","license":[{"start":{"date-parts":[[1989,3,25]],"date-time":"1989-03-25T00:00:00Z","timestamp":606787200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1989,3,25]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bmj.298.6676.795","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T15:19:55Z","timestamp":1238685595000},"page":"795-801","source":"Crossref","is-referenced-by-count":301,"title":["Effects on birth weight of smoking, alcohol, caffeine, socioeconomic factors, and psychosocial stress."],"prefix":"10.1136","volume":"298","author":[{"given":"O. G.","family":"Brooke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. R.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Bland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. L.","family":"Peacock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. M.","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1989,3,25]]},"reference":[{"key":"ref_1","article-title":"1989 cohabiting partner was coded according to the Registrar General's classification.' Net disposable income each week was assessed twice. The current mood of the mother was measured on three occasions with the 28 item general health questionnaire.6 This allowed us to assess anxiety and depression without including somatic symptoms and social dysfunction, which could be an effect of pregnancy rather than of mental illness. Previous psychiatric treatment was recorded. To measure stress an inventory of life events modified from Paykel's interview for recent life events was taken. Satisfaction and happiness with accommodation, neighbours, and neighbourhood were recorded on a four point scale. The same method was used to measure perceived difficulties in overall finances and in affording accommodation, food, heating, and clothing","author":"M.A.R.C.H.","unstructured":"MARCH 1989 cohabiting partner was coded according to the Registrar General's classification.' Net disposable income each week was assessed twice. The current mood of the mother was measured on three occasions with the 28 item general health questionnaire.6 This allowed us to assess anxiety and depression without including somatic symptoms and social dysfunction, which could be an effect of pregnancy rather than of mental illness. Previous psychiatric treatment was recorded. To measure stress an inventory of life events modified from Paykel's interview for recent life events was taken. Satisfaction and happiness with accommodation, neighbours, and neighbourhood were recorded on a four point scale. The same method was used to measure perceived difficulties in overall finances and in affording accommodation, food, heating, and clothing."},{"key":"ref_2","first-page":"1131","article-title":"Social aspects of low birthweight","volume":"7","author":"Dunn, H.G.","year":"1984","unstructured":"Dunn HG. Social aspects of low birthweight. Can Med Assoc 7 1984;130: 1131-40.","journal-title":"Can Med Assoc"},{"key":"ref_3","article-title":"States Surgeon General. The health consequences of'smokingfor women: report","author":"States Department of Health and Human Services, Public Health Service, Office of the","year":"1980","unstructured":"United States Surgeon General. The health consequences of'smokingfor women: report. Washington: United States Department of Health and Human Services, Public Health Service, Office of the Assistant Secretarv for Health, Office on Smoking and Health, 1980."},{"key":"ref_4","article-title":"McCance and Widdowson's the composition offoods","author":"Paul, A.A.; Southgate, D.A.T.","year":"1978","unstructured":"Paul AA, Southgate DAT. McCance and Widdowson's the composition offoods. 4th ed. London: HMSO, 1978.","edition":"4th ed"},{"key":"ref_5","article-title":"Population Censuses and Surveys. Classification of occupations","author":"Office of","year":"1980","unstructured":"Office of Population Censuses and Surveys. Classification of occupations. London: HMSO, 1980."},{"key":"ref_6","first-page":"139","article-title":"A scale version of the general health questionnaire","volume":"9","author":"Goldberg, D.P.; X'F, Hillier","year":"1979","unstructured":"Goldberg DP, Hillier X'F. A scale version of the general health questionnaire. PsvcholMed 1979;9:139-45.","journal-title":"PsvcholMed"},{"key":"ref_7","article-title":"Manual for shte Evsenck personality inventour","author":"Eysenck, H.J.; Eysenck, S.B.G.","year":"1964","unstructured":"Eysenck HJ, Eysenck SBG. Manual for shte Evsenck personality inventour. London: London University Press, 1964."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1136\/adc.60.5.440","article-title":"Birthweight between 14 and 42 weeks'","volume":"60","author":"Keen, D.V.; Pearse, R.G.","year":"1985","unstructured":"Keen DV, Pearse RG. Birthweight between 14 and 42 weeks' gestation. Arch Dis Child 1985;60:440-6.","journal-title":"gestation. Arch Dis Child"},{"key":"ref_9","article-title":"Development and explottasion of empirical birthweight standards","author":"Carr-Hill, R.; Pritchard, C.","year":"1985","unstructured":"Carr-Hill R, Pritchard C. Development and explottasion of empirical birthweight standards. London: M\\acmillan Press, 1985."},{"key":"ref_10","first-page":"746","article-title":"Confidence intervals rather than P values: estimation rather than hypothesis testing","volume":"292","author":"Gardner, M.J.; Altman, D.G.","year":"1986","unstructured":"Gardner MJ, Altman DG. Confidence intervals rather than P values: estimation rather than hypothesis testing. BrMedj 1986;292:746-50.","journal-title":"BrMedj"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1136\/bmj.295.6600.687","article-title":"Is birth weight determined genetically?","volume":"295","author":"Carr-Hill, R.; Campbell, D.M.; Hall, M.H.; Meredith, A.","year":"1987","unstructured":"Carr-Hill R, Campbell DM, Hall MH, Meredith A. Is birth weight determined genetically? Br Med]E 1987;295:687-9.","journal-title":"Br Med]E"},{"key":"ref_12","first-page":"249","article-title":"Relationship between cigarette smoking and social class to birthweight and perinatal mortality among all births in Britain","volume":"37","author":"Rush, D.; Cassano, P.","year":"1970","unstructured":"Rush D, Cassano P. Relationship between cigarette smoking and social class to birthweight and perinatal mortality among all births in Britain, 5-11 April 1970. ] Epidemiol Community Health 1983;37:249-55.","journal-title":"Epidemiol Community Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1093\/oxfordjournals.aje.a121278","article-title":"The relationship of parents' cigarette smoking to outcome of pregnancy-implications as to the problem of inferring causation from observed associations","volume":"93","author":"Yerushalmv, J.","year":"1971","unstructured":"Yerushalmv J. The relationship of parents' cigarette smoking to outcome of pregnancy-implications as to the problem of inferring causation from observed associations. Am] Epidemiol 1971;93:443-56.","journal-title":"Am] Epidemiol"},{"key":"ref_14","first-page":"451","article-title":"Relation between tobacco smoking of pregnant women and body size of their pregnancy: a compilation and synthesis of published studies","volume":"47","author":"Mieridith, H.V.","year":"1975","unstructured":"Mieridith HV. Relation between tobacco smoking of pregnant women and body size of their pregnancy: a compilation and synthesis of published studies. Hum Biol 1975;47:451-72.","journal-title":"Hum Biol"},{"key":"ref_15","first-page":"415","article-title":"Effect of passive smoking on birth-weight","volume":"ii:","author":"Rubin, D.H.; Krasilnikoff, P.A.; Leventhan, J.M.; Weile, B.; Berget, A.","year":"1986","unstructured":"Rubin DH, Krasilnikoff PA, Leventhan JM, Weile B, Berget A. Effect of passive smoking on birth-weight. Lancet 1986;ii:415-7.","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/S0140-6736(86)90253-9","article-title":"Passis-e smoking, birthweight and oestrogens","volume":"ii:","author":"Trichopoulos, D.","year":"1986","unstructured":"Trichopoulos D. Passis-e smoking, birthweight and oestrogens. Lancet 1986;ii: 743.","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/S0140-6736(86)92906-5","article-title":"Misclassification as a risk factor in passive smoking risk","volume":"ii:","author":"Lee, P.N.","year":"1986","unstructured":"Lee PN. Misclassification as a risk factor in passive smoking risk. Lancet 1986;ii:867.","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1093\/oxfordjournals.aje.a114436","article-title":"Association of low birth weight with passive smoke exposure in pregnancy","volume":"124","author":"Martin, T.R.; Bracken, M.B.","year":"1986","unstructured":"Martin TR, Bracken MB. Association of low birth weight with passive smoke exposure in pregnancy. Am] Epidemiol 1986;124:633-42.","journal-title":"Am] Epidemiol"},{"key":"ref_19","article-title":"Alcohol: our favourite drug","author":"of Psychiatrists, Royal College","year":"1986","unstructured":"Royal College of Psychiatrists. Alcohol: our favourite drug. London: Tavistock Publications, 1986."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1360-0443.1985.tb05284.x","article-title":"Adverse effects of alcohol in pregnancy","volume":"80","author":"Barrison, I.G.; Waterson, E.J.; AMurray-Lyon, I.M.","year":"1985","unstructured":"Barrison IG, Waterson EJ, AMurray-Lyon IM. Adverse effects of alcohol in pregnancy. Br] Addict 1985;80:11-22.","journal-title":"Br] Addict"},{"key":"ref_21","first-page":"663","article-title":"Alcohol consumption, pregnancy and low birthweight","volume":"i:","author":"Wright, J.T.; Waterson, E.J.; Barrison, I.G.","year":"1983","unstructured":"Wright JT, Waterson EJ, Barrison IG, et al. Alcohol consumption, pregnancy and low birthweight. Lancet 1983;i:663-5.","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1093\/ije\/16.1.44","article-title":"Cigarettes, alcohol and marijuana: varying associations with birthweight","volume":"16","author":"Kline, J.; Stein, Z.; Hutzler, M.","year":"1987","unstructured":"Kline J, Stein Z, Hutzler M. Cigarettes, alcohol and marijuana: varying associations with birthweight. Intj Epidemiol 1987;16:44-5 1.","journal-title":"Intj Epidemiol"},{"key":"ref_23","first-page":"1500","article-title":"Alcohol consumption in Dundee primigravidas and its effect on outcome of pregnancy","volume":"2","author":"Sulaiman, N.D.; duV, Florev C.; Taylor, D.J.; Ogston, S.A.","year":"1988","unstructured":"Sulaiman ND, Florev C duV, Taylor DJ, Ogston SA. Alcohol consumption in Dundee primigravidas and its effect on outcome of pregnancy. Br Med J 1988;2%: 1500-3.","journal-title":"Br Med J"},{"key":"ref_24","first-page":"9","article-title":"Maternal caffeine use before, during and after pregnancy and effects upon offspring","volume":"7","author":"Watkinson, B.; Fried, P.A.","year":"1985","unstructured":"Watkinson B, Fried PA. Maternal caffeine use before, during and after pregnancy and effects upon offspring. Neurobehavioural Toxicology and TeratoloV 1985;7:9-17.","journal-title":"Neurobehavioural Toxicology and TeratoloV"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1056\/NEJM198201213060304","article-title":"No association between coffee consumption and adverse outcomes of pregnancy","volume":"306","author":"Linn, S.; Schoenbaum, S.G.; Monson, R.R.; Rosner, B.; Stubblefield, P.G.; Ryan, K.J.","year":"1982","unstructured":"Linn S, Schoenbaum SG, Monson RR, Rosner B, Stubblefield PG, Ryan KJ. No association between coffee consumption and adverse outcomes of pregnancy. IX EnglJMed 1982;306:141-5.","journal-title":"IX EnglJMed"},{"key":"ref_26","first-page":"353","article-title":"Maternal nutrition, birthweight and infant mortality","author":"Habicht, J.-P.; Lechtig, A.; Yarbrough, C.; Klein, R.E.","year":"1974","unstructured":"Habicht J-P, Lechtig A, Yarbrough C, Klein RE. Maternal nutrition, birthweight and infant mortality. In: Elliott K, Knight J, eds. Size at birth. Amsterdam: Elsesier, 1974:353-70. (Ciba Foundation Symposium 27.)"},{"key":"ref_27","article-title":"Public health aspects of low birthweight. WHO Tech Rep Ser 1961; No 217","author":"Baird, D.","unstructured":"Baird D. Public health aspects of low birthweight. WHO Tech Rep Ser 1961;No 217."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1093\/ajcn\/36.6.1214","article-title":"Pregnancy outcome in N American women. 2. Effects of diet, cigarette smoking, stress and weight gain on placentas, and on neonatal physical and behavioural characteristics","volume":"36","author":"Picone, T.A.; Allen, L.H.; Olsen, P.N.; Ferris, M.E.","year":"1982","unstructured":"Picone TA, Allen LH, Olsen PN, Ferris ME. Pregnancy outcome in N American women. 2. Effects of diet, cigarette smoking, stress and weight gain on placentas, and on neonatal physical and behavioural characteristics. AmJ Clin Nutr 1982;36:1214-24.","journal-title":"AmJ Clin Nutr"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1017\/S0033291700050959","article-title":"Psychosocial factors and obstetric complications","volume":"13","author":"Chalmers, B.","year":"1983","unstructured":"Chalmers B. Psychosocial factors and obstetric complications. Psvchol Med 1983;13:333-9.","journal-title":"Psvchol Med"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"30","DOI":"10.2307\/2136301","article-title":"Life stress, social support, and emotional disequilibrium in complications of pregnancy: a prospective, multivariate study","volume":"24","author":"Norbeck, J.S.; Tilden, V.P.","year":"1983","unstructured":"Norbeck JS, Tilden VP. Life stress, social support, and emotional disequilibrium in complications of pregnancy: a prospective, multivariate study.JHealth Soc Behav 1983;24:30-46.","journal-title":"JHealth Soc Behav"},{"key":"ref_31","first-page":"291","article-title":"Social adversity, low birth weight, and preterm delivery","volume":"295","author":"Stein, A.; Campbell, E.A.; Day, A.; McPherson, K.; Cooper, P.J.","year":"1987","unstructured":"Stein A, Campbell EA, Day A, McPherson K, Cooper PJ. Social adversity, low birth weight, and preterm delivery. BrMedJ 1987;295:291-3.","journal-title":"BrMedJ"},{"key":"ref_32","first-page":"1191","article-title":"Psvchosocial stress in pregnancy and its relation to low birth weight","volume":"288","author":"Newton, R.W.; Hunt, L.P.","year":"1984","unstructured":"Newton RW, Hunt LP. Psvchosocial stress in pregnancy and its relation to low birth weight. BrMedj 1984;288:1191-4.","journal-title":"BrMedj"},{"key":"ref_33","first-page":"411","article-title":"Psychosocial stress in pregnancy and its relation to the onset of premature labour","volume":"ii:","author":"Newton, R.W.; Webster, P.A.C.; Binu, P.S.; Mlaskrey, N.; Phillips, A.B.","year":"1979","unstructured":"Newton RW, Webster PAC, Binu PS, Mlaskrey N, Phillips AB. Psychosocial stress in pregnancy and its relation to the onset of premature labour. BrMedj 1979;ii:411-3.","journal-title":"BrMedj"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1037\/0033-2909.100.3.331","article-title":"Stress, anxiety and birth outcomes: a critical res-iew of the evidence","volume":"100","author":"Ists-an, J.","year":"1986","unstructured":"Ists-an J. Stress, anxiety and birth outcomes: a critical res-iew of the evidence. Psvchol Bull 1986;100:331-48.","journal-title":"Psvchol Bull"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.298.6676.795","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.298.6676.795","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T06:37:15Z","timestamp":1765262235000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.298.6676.795"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1989,3,25]]},"references-count":34,"journal-issue":{"issue":"6676","published-online":{"date-parts":[[1989,3,25]]},"published-print":{"date-parts":[[1989,3,25]]}},"alternative-id":["10.1136\/bmj.298.6676.795"],"URL":"https:\/\/doi.org\/10.1136\/bmj.298.6676.795","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1989,3,25]]}}}