Social support during pregnancy can affect fetal growth and birth weight

September 21, 2000

An infant's birth weight may be affected by the amount of social support the mother receives during pregnancy, according to a new study.

"It is critical that psychosocial risk factors that contribute to low birth weight and fetal growth restriction are identified -- especially given the implications for infant morbidity and mortality, healthcare costs, and parenting stress," said lead author Pamela Feldman, PhD, of the Department of Epidemiology and Public Health at University College London, UK.

The study was conducted at the University of California at Los Angeles and the University of California at Irvine by an interdisciplinary team that interviewed nearly 250 pregnant women, asking if the baby's father would help them financially and otherwise with the baby, if their parents would be there for them, and if they had friends to turn to for support and assistance.

Women with several types of support from different sources during pregnancy had higher birth weight infants, Feldman and colleagues found.

The relationship between social support and birth weight held even after the researchers took into account other factors often associated with low birth weight, including premature delivery, a history of stillbirth or spontaneous abortion, and medical conditions such as hypertension or epilepsy.

The researchers report their findings in the September/October issue of Psychosomatic Medicine.

"That social support is an important predictor of birth weight is emphasized by the finding that it predicts birth weight independently but to the same extent as these well known medical determinants of birth weight," said Feldman.

Rather than contributing to the timing of delivery, social support appears to contribute to birth weight by enhancing fetal growth processes. Social support may alter responses of the nervous system to stress and improve fetal growth, the researchers speculated.

Previous studies found that stress contributed to premature births through its effect on the nervous system, but more research is needed to determine if social support affects fetal growth and subsequent birth weight similarly.

Social support may also inspire healthier behaviors and lifestyles among pregnant women and discourage behaviors like smoking, substance use, and poor nutritional intake -- all risk factors for low birth weight infants.

In addition, pregnant women with more social support may be more likely to receive treatment for diseases associated with low infant birth weight, such as high blood pressure, heart disease, and sickle cell disease, according to the study.

Previously tested social support efforts for pregnant women have tended to involve intermittent provision of informational and emotional support by nurses, social workers, or lay educators.

"Our findings suggest several types of support from different sources influence fetal growth and birth weight," said Feldman. "Interventions need to bolster the support provided within a woman's existing social network rather than just providing external support."

More research is needed to determine the best ways to support those women with less access to social support during pregnancy -- and who may be at higher risk of having a lower birth weight infant, according to the researchers.

"Also, future studies may build on these findings by investigating the biological and behavioral pathways that link social support to fetal growth," said Feldman.
Christine Dunkel-Schetter, PhD, Curt A. Sandman, PhD, and Pathik D. Wadhwa, MD, PhD, conducted the study along with Feldman and colleagues.

This study was funded in part by grants from the U.S. Public Health Service, National Institute for Child Health and Human Development, and the National Institute of Mental Health.

Psychosomatic Medicine is the official bimonthly peer-reviewed journal of the American Psychosomatic Society. For information about the journal, contact Joel E. Dimsdale, MD, at (619) 543-5468.

Posted by the Center for the Advancement of Health, For information about the Center, call Petrina Chong, (, (202) 387-2829.

Center for Advancing Health

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