Psychological distress in pregnancy and preterm delivery

M Hedegaard, T B Henriksen, S Sabroe, N J Secher, M Hedegaard, T B Henriksen, S Sabroe, N J Secher

Abstract

Objective: To investigate if psychological distress during pregnancy is associated with increased risk of preterm delivery.

Design: Prospective, population based, follow up study with repeated measures of psychological distress (general health questionnaire), based on the use of questionnaires.

Setting: Antenatal care clinic and delivery ward, Aarhus University Hospital, Denmark.

Subjects: 8719 women with singleton pregnancies attending antenatal care for the initial visit between 1 August 1989 and 30 September 1991; 5872 women (67%) completed all questionnaires.

Main outcome measure: Preterm delivery. Estimation of gestational age at delivery was mainly based on early ultrasound measurements.

Results: In 197 cases (3.6%) the woman delivered prematurely (less than 259 days). A dose-response relation between psychological distress in the 30th week of pregnancy and risk of preterm delivery was found, but distress measured in the 16th week was not related to preterm delivery. Control of confounding was secured by the use of multivariate logistic regression models. Relative risk for preterm delivery was 1.22 (95% confidence interval 0.84 to 1.79) for moderate distress and 1.75 (1.20 to 2.54) for high distress in comparison to low distress.

Conclusions: Psychological distress later in pregnancy is associated with an increased risk of preterm delivery. Future interventional studies should focus on ways of lowering psychological distress in late pregnancy.

References

    1. Br Med J (Clin Res Ed). 1987 Aug 1;295(6593):291-3
    1. Br J Obstet Gynaecol. 1991 Feb;98(2):166-72
    1. Psychosom Med. 1968 Mar-Apr;30(2):222-43
    1. Am J Epidemiol. 1972 May;95(5):431-41
    1. J Psychosom Res. 1975 Apr;19(2):123-9
    1. Acta Obstet Gynecol Scand Suppl. 1978;78:5-14
    1. J Psychosom Res. 1980;24(6):343-51
    1. J Psychosom Res. 1983;27(4):283-90
    1. Neuroendocrinology. 1983 Oct;37(4):314-6
    1. Br Med J (Clin Res Ed). 1984 Apr 21;288(6425):1191-4
    1. Clin Obstet Gynecol. 1984 Sep;27(3):539-52
    1. N Engl J Med. 1985 Jan 10;312(2):82-90
    1. Acta Obstet Gynecol Scand. 1985;64(1):65-70
    1. Lancet. 1986 Jan 11;1(8472):55-7
    1. N Engl J Med. 1992 Oct 29;327(18):1266-71
    1. Bull World Health Organ. 1987;65(5):663-737
    1. Psychopathology. 1987;20(3-4):169-79
    1. Acta Paediatr Scand. 1988 May;77(3):340-8
    1. Lancet. 1988 Jul 23;2(8604):204-7
    1. Dev Med Child Neurol. 1988 Aug;30(4):482-91
    1. Am J Psychiatry. 1988 Dec;145(12):1507-13
    1. Am J Public Health. 1989 Mar;79(3):340-9
    1. Br J Obstet Gynaecol. 1989 Mar;96(3):281-8
    1. BMJ. 1989 Mar 25;298(6676):795-801
    1. Am J Public Health. 1990 Feb;80(2):173-7
    1. Br J Obstet Gynaecol. 1990 Feb;97(2):155-62
    1. N Engl J Med. 1990 Oct 11;323(15):1040-5

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren