Help with prenatal household tasks and newborn birth weight: Is there an association?

Although prenatal psychosocial factors influence pregnancy outcome, the specific components of prenatal social support which affect infants' birth weight have not been examined prospectively. To define those elements of prenatal social support which are associated with newborn birth weights, we studied 198 indigent mothers seen consecutively by a social worker at a community hospital-based obstetrical clinic. At the first prenatal clinic visit, we used the Maternal Social Support Index (MSSI) to assess the availability of help with daily tasks, a communicative male and other adults, emergency child care, and community involvement. The only MSSI item related to low birth weight (LBW ≥ 2,500 g) for both multigravida and primigravida mothers was daily task sharing. Help with grocery shopping and the process of paying bills (p = 0.03) and working outside (p = 0.005). Help with things around the house was associated with LBW for both multigravida (p = 0.02) and primigravida (p = 0.04) mothers. Car availability was associated with low birth weight only for multigravida mothers (p = 0.006). Stepwise discriminant function analysis was performed for multigravida mothers. Low birth weight was the dependent variable. Eight wellknown risk factors for low birth weight (excluding daily tasks) were the independent variables. The “best” function included marital status, maternal age, gravidity, and smoking during pregnancy. The addition of daily task-sharing to this model increased sensitivity (low birth weight classified low birth weight by the model) from 21% to 50%. These data support the importance of the social environment during pregnancy, and suggest that subsequent research which examines the etiology of low birth weight must address the complex interaction of social, psychological, and physical health.