Electronic Theses and Dissertations

Identifier

1301

Date

2014

Date of Award

12-3-2014

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Social and Behavioral Sciences

Committee Chair

Satish Kedia

Committee Member

Kenneth Ward

Committee Member

Marian Levy

Committee Member

George Relyea

Abstract

Preterm birth (PTB), an infant born with less than 37 weeks gestation, and small for gestional age (SGA), a constitutionally small or growth restricted infant, are the leading causes of infant mortality. There is a growing disparity in PTB and SGA by race, with African American women having the highest rates of all racial groups. Accounting for socioeconomic, behavioral and obstetric risk factors has not fully explained the racial disparity in birth outcomes.The goal of this dissertation was to determine if lifetime exposure to traumatic stress, measured by the Traumatic Life Events Questionaire (TLEQ), contributes to the disparity in PTB and SGA between African American and White women. We hypothesized that African American women would experience more traumatic stress than White women, and traumatic stress would be associated with PTB and SGA.Women for this study were participants in a longitudinal study (CANDLE) following mother child dyads prenatally through age 4 in Shelby County, TN. A subset of 1,313 women (877 African American and 436 White) who completed the TLEQ during the second trimester of pregnancy and had documented live births were included in this study. African American infants weighed significantly less at birth than White infants(3.2 kg, SD = 0.49 vs. 3.4 kg, SD = 0.49, p = .039, respectively).There were no statistically significant differences in PTB or SGA between African American and White women. More African American women experienced a traumatic event than White Women (75% vs. 70%, p < .05, respectively). Out of 20 traumatic events, only experiencing intimate partner violence was associated with SGA (OR 0.52, 95% CI[0.28, 0.94]),and having a loved one face a life threatening event was associated with a 91g decrease in birth weight (B = -0.09, p = .001). PTB was not associated with any traumatic event.There were high rates of traumatic stress in this relatively health sample of pregnant women, yet only two types of traumatic events were associated with birth outcomes. Traumatic stress should be further examined in a more representative sample of pregnant women to better understand its affects on birth outcomes.

Comments

Data is provided by the student.

Library Comment

dissertation or thesis originally submitted to the local University of Memphis Electronic Theses & dissertation (ETD) Repository.

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