Effect of maternal stress during pregnancy on the risk for preterm birth

Caroline Lilliecreutz, Johanna Larén, Gunilla Sydsjö, Ann Josefsson, Caroline Lilliecreutz, Johanna Larén, Gunilla Sydsjö, Ann Josefsson

Abstract

Background: Preterm birth defined as birth prior to 37 weeks of gestation is caused by different risk factors and implies an increased risk for disease and early death for the child. The aim of the study was to investigate the effect of maternal stress during pregnancy on the risk of preterm birth.

Methods: A case-control study that included 340 women; 168 women who gave birth preterm and 172 women who gave birth at term. Data were manually extracted from standardized medical records. If the medical record contained a psychiatric diagnosis or a self-reported stressor e.g., depression or anxiety the woman was considered to have been exposed to stress during pregnancy. Adjusted odds ratio (AOR) was used to calculate the attributable risk (AR) of maternal stress during pregnancy on preterm birth, both for the women exposed to stress during pregnancy (AR1 = (AOR-1)/AOR) and for the whole study population (AR2 = AR1*case fraction).

Results: Maternal stress during pregnancy was more common among women who gave birth preterm compared to women who gave birth at term (p <0.000, AOR 2.15 (CI = 1.18-3.92)). Among the women who experienced stress during pregnancy 54% gave birth preterm with stress as an attributable risk factor. Among all of the women the percentage was 23%.

Conclusions: Stress seems to increase the risk of preterm birth. It is of great importance to identify and possibly alleviate the exposure to stress during pregnancy and by doing so try to decrease the preterm birth rate.

References

    1. Keller M, Felderhoff-Mueser U, Lagercrantz H, Dammann O, Marlow N, Huppi P, et al. Policy benchmarking report on neonatal health and social policies in 13 European countries. Acta Paediatr. 2010;11:1624–1629. doi: 10.1111/j.1651-2227.2010.01894.x.
    1. Murphy DJ. Epidemiology and environmental factors in preterm labour. Best Pract Res Clin Obstet Gynaecol. 2007;5:773–789. doi: 10.1016/j.bpobgyn.2007.03.001.
    1. Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008;9608:261–269. doi: 10.1016/S0140-6736(08)60136-1.
    1. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;9606:75–84. doi: 10.1016/S0140-6736(08)60074-4.
    1. Crump C, Sundquist K, Sundquist J, Winkleby MA. Gestational age at birth and mortality in young adulthood. JAMA. 2011;11:1233–1240. doi: 10.1001/jama.2011.1331.
    1. Bladh M, Josefsson A, Carstensen J, Finnström O, Sydsjö G. Intergenerational cohort study of preterm and small-for-gestational-age birth in twins and singletons. Twin Res Hum Genet. 2015;18:581–90. doi: 10.1017/thg.2015.60.
    1. Federenko IS, Wadhwa PD. Women's mental health during pregnancy influences fetal and infant developmental and health outcomes. CNS Spectr. 2004;9:198–206.
    1. Entringer S, Buss C, Wadhwa PD. Prenatal stress, development, health and disease risk: a psychobiological perspective-2015 Curt Richter Award Paper. Psychoneuroendocrinology. 2015;62:366–375. doi: 10.1016/j.psyneuen.2015.08.019.
    1. Wadhwa PD, Culhane JF, Rauh V, Barve SS. Stress and preterm birth: neuroendocrine, immune/inflammatory, and vascular mechanisms. Matern Child Health J. 2001;5:119–125. doi: 10.1023/A:1011353216619.
    1. Hoirisch-Clapauch S, Brenner B, Nardi AE. Adverse obstetric and neonatal outcomes in women with mental disorders. Thromb Res. 2015;135.
    1. Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. Women Birth. 2015;28:179–93. doi: 10.1016/j.wombi.2015.02.003.
    1. Christian LM. Effects of stress and depression on inflammatory immune parameters in pregnancy. Am J Obstet Gynecol. 2014;211:275–7. doi: 10.1016/j.ajog.2014.06.042.
    1. Glover V. Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms. Adv Neurobiol. 2015;10:269–83. doi: 10.1007/978-1-4939-1372-5_13.
    1. Brown S, Yelland J, Sutherland G, Baghurst P, Robinson J. Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort: challenges and opportunities in antenatal care. BMC Public Health. 2011;11:196. doi: 10.1186/1471-2458-11-196.
    1. Straub H, Adams M, Kim JJ, Silver RK. Antenatal depressive symptoms increase the likelihood of preterm birth. Am J Obstet Gynecol. 2012;207:329e1–4. doi: 10.1016/j.ajog.2012.06.033.
    1. Wisner KL, Si DK, Hanusa BH, Moses-Kolko EL, Bogen DL, Hunker DF, et al. Major depression and antidepressant treatment: impact on pregnancy and neonatal outcomes. Am J Psychiatry. 2009;5:557–566. doi: 10.1176/appi.ajp.2008.08081170.
    1. Grigoriadis S, Vonder Porten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry. 2013;74:321–41. doi: 10.4088/JCP.12r07968.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться