MATERIALS AND METHODS
We studied pregnant women enrolled in a longitudinal study of antenatal care at a single university obstetric clinic. The clinic serves a group of women with diversity in race, socioeconomic status, and medical risk. As part of a psychosocial screening program, questionnaires measuring stress and mood were introduced in January 2004. Questionnaires were designed to be distributed by clinical staff as part of routine clinical care to all women at least once during pregnancy. All women receiving ongoing obstetric care and completing at least 1 questionnaire from January 2004 through March 2008 were eligible for inclusion in the study.
Data were collected from self-report questionnaires and from automated medical records. The questionnaire included
inquiry regarding demographic characteristics, social history, medication use, general health history, and past obstetric complications as well as validated measures assessing psychosocial stress; depression and panic disorder; tobacco, alcohol, and drug use; and domestic violence. Psychosocial stress was measured by means of the Prenatal Psychosocial Profile stress scale, which has been validated for use in pregnant populations.