Model of perinatal care but not prenatal stress exposure is associated with birthweight and gestational age at Birth: The Australian birth in the time of COVID (BITTOC) study

Mia A McLean; Chloé Klimos; Belinda Lequertier; Hazel Keedle; Guillaume Elgbeili; Sue Kildea; Suzanne King; Hannah G Dahlen

doi:10.1016/j.srhc.2024.100981

Model of perinatal care but not prenatal stress exposure is associated with birthweight and gestational age at Birth: The Australian birth in the time of COVID (BITTOC) study

Sex Reprod Healthc. 2024 May 6:40:100981. doi: 10.1016/j.srhc.2024.100981. Online ahead of print.

Authors

Mia A McLean¹, Chloé Klimos², Belinda Lequertier³, Hazel Keedle⁴, Guillaume Elgbeili⁵, Sue Kildea³, Suzanne King⁶, Hannah G Dahlen⁷

Affiliations

¹ School of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand; BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
² Department of Psychology, McGill University, Montreal, QC, Canada.
³ Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia.
⁴ School of Nursing and Midwifery, Western Sydney University, Sydney, NSW, Australia.
⁵ Douglas Institute Research Centre, Verdun, QC, Canada.
⁶ Douglas Institute Research Centre, Verdun, QC, Canada; Department of Psychiatry, McGill University, Montreal, QC, Canada.
⁷ School of Nursing and Midwifery, Western Sydney University, Sydney, NSW, Australia. Electronic address: h.dahlen@westernsydney.edu.au.

PMID: 38739983
DOI: 10.1016/j.srhc.2024.100981

Abstract

Objective: The present study aimed to understand, relative to standard care, whether continuity of care models (private midwifery, continuity of care with a private doctor, continuity of care with a public midwife), and women's experience of maternity care provision, during the perinatal period buffered the association between prenatal maternal stress (PNMS) and infant birth outcomes (gestational age [GA], birth weight [BW] and birth weight for gestational age [BW for GA]).

Methods: 2207 women who were pregnant in Australia while COVID-19 restrictions were in place reported on their COVID-19 related objective hardship and subjective distress during pregnancy and provided information on their model of maternity care. Infant birth outcomes (BW, GA) were reported on at 2-months postpartum.

Results: Multiple linear regressions showed no relationship between PNMS and infant BW, GA or BW for GA, and neither experienced continuity of care, nor model of maternity care moderated this relationship. However, compared with all other models of care, women enrolled in private midwifery care reported the highest levels of experienced continuity of care and birthed infants at higher GA. BW and BW for GA were higher in private midwifery care, relative to standard care.

Conclusion: Enrollment in continuous models of perinatal care may be a better predictor of infant birth outcomes than degree of PNMS exposure. These results highlight the possibility that increased, continuous support to women during pregnancy may play an important role in ensuring positive infant birth outcomes during future pandemics.