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Associations of Maternal Trait Anger Expression and Lifetime Traumatic and Non-traumatic Experiences with Preterm Birth.

Authors
  • Cowell, Whitney1
  • Taing, Lilly2
  • Askowitz, Talia3
  • Bosquet Enlow, Michelle4, 5
  • Hacker, Michele R6, 7, 8
  • Wright, Rosalind J9, 3
  • 1 Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA. [email protected]
  • 2 Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • 3 Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • 4 Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
  • 5 Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA.
  • 6 Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA. , (Israel)
  • 7 Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA.
  • 8 Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
  • 9 Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Type
Published Article
Journal
Maternal and child health journal
Publication Date
Apr 01, 2021
Volume
25
Issue
4
Pages
635–644
Identifiers
DOI: 10.1007/s10995-020-03026-x
PMID: 33206302
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Most studies examining psychosocial factors contributing to preterm birth (PTB) have focused on negative life events. Studies examining the influence of negative emotion, in particular maternal anger, remain sparse. We examined associations of maternal trait anger expression and lifetime traumatic and non-traumatic experiences with the risk of PTB. Mother-newborn pairs were enrolled in the PRogramming of Intergenerational Stress Mechanisms pregnancy cohort based in Boston and New York City. Women completed the State-Trait Anger Expression Inventory-2 (STAXI-2), Life Stressor Checklist-Revised (LSC-R), and Childhood Trauma Questionnaire (CTQ) in pregnancy. We used modified Poisson regression to estimate the relative risk (RR) of PTB (1) in relation to continuous STAXI-2 Anger Expression-In (AX-I) and Anger Expression-Out (AX-O) subscales, (2) in relation to continuous LSC-R scores, and (3) between women who did versus did not experience childhood sexual, emotional, and/or physical abuse in six separate models. We also examined interactions between maternal anger expression and lifetime stress/childhood trauma. Younger, single, minority women had higher outward anger expression and inward anger suppression. AX-I and AX-O scores were higher among women who experienced abuse in childhood and who had higher lifetime stress. Maternal lifetime stress, outward anger expression, and inward anger suppression were associated with an increased risk of PTB in separate models; however, stress, trauma and anger did not interact to further increase the risk of PTB. CONCLUSIONS FOR PRACTICE: Higher anger expression and higher lifetime stress experiences were associated with an increased risk of PTB among a racially and ethnically diverse sample of pregnant women.

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