The purpose of the study is to investigate the influence of psychosocial stress, maternal schooling, social support, psychological well-being, alcohol and smoking on intrauterine growth retardation and premature delivery. At a Copenhagen university hospital 2432 consecutive Danish-speaking women in 20th week of pregnancy completed a questionnaire including the General Health Questionnaire and Severity of Psychosocial Stressor Scale and questions about social network, education, smoking and drinking habits. In 212 cases (8.7%) the women delivered before day 259 of gestation. In a multiple logistic regression model, pre-term delivery proved to be associated with psychosocial stress and poor school education. In 152 cases (6.3%) infants had a birth weight below the defined 10th percentile. In a multiple logistic regression model, IUGR was associated with smoking. In preventive programmes, such as anti-smoking campaigns, it should be kept in mind that women who smoke are also the least educated and have the poorest support from a social network.
In a population-based study, 3021 women in a central Copenhagen district received a questionnaire on environmental and psychological factors during mid-gestation. Of these, 70 women were selected consecutively on the basis of moderate to severe stressful life-events (DSM-III-R categories 3 to 5), in combination with an inadequate social network. They were compared with 50 non-stressed women with an intact social network. Stress and smoking significantly affected birthweight and head circumference. When birthweight was corrected, stress remained a significant determinant of small head circumference, indicating a specific effect on brain development. Stress also led to a suboptimal Prechtl neonatal neurological score. These findings suggest the existence of a fetal stress syndrome with adverse effects on fetal development, including deficient brain development.