Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

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

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

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

Login to get access

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.
Literature
1.
go back to reference 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;11:1624–9. 10.1111/j.1651-2227.2010.01894.xCrossRef 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;11:1624–9. 10.1111/j.1651-2227.2010.01894.xCrossRef
2.
go back to reference Murphy DJ. Epidemiology and environmental factors in preterm labour. Best Pract Res Clin Obstet Gynaecol. 2007;5:773–89. 10.1016/j.bpobgyn.2007.03.001CrossRef Murphy DJ. Epidemiology and environmental factors in preterm labour. Best Pract Res Clin Obstet Gynaecol. 2007;5:773–89. 10.1016/j.bpobgyn.2007.03.001CrossRef
3.
go back to reference Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008;9608:261–9. 10.1016/S0140-6736(08)60136-1CrossRef Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008;9608:261–9. 10.1016/S0140-6736(08)60136-1CrossRef
4.
go back to reference Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;9606:75–84. 10.1016/S0140-6736(08)60074-4CrossRef Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;9606:75–84. 10.1016/S0140-6736(08)60074-4CrossRef
5.
go back to reference Crump C, Sundquist K, Sundquist J, Winkleby MA. Gestational age at birth and mortality in young adulthood. JAMA. 2011;11:1233–40. 10.1001/jama.2011.1331CrossRef Crump C, Sundquist K, Sundquist J, Winkleby MA. Gestational age at birth and mortality in young adulthood. JAMA. 2011;11:1233–40. 10.1001/jama.2011.1331CrossRef
6.
go back to reference 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. 26330196, 10.1017/thg.2015.60CrossRefPubMed 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. 26330196, 10.1017/thg.2015.60CrossRefPubMed
7.
go back to reference Federenko IS, Wadhwa PD. Women's mental health during pregnancy influences fetal and infant developmental and health outcomes. CNS Spectr. 2004;9:198–206. 14999160CrossRefPubMed Federenko IS, Wadhwa PD. Women's mental health during pregnancy influences fetal and infant developmental and health outcomes. CNS Spectr. 2004;9:198–206. 14999160CrossRefPubMed
8.
go back to reference Entringer S, Buss C, Wadhwa PD. Prenatal stress, development, health and disease risk: a psychobiological perspective-2015 Curt Richter Award Paper. Psychoneuroendocrinology. 2015;62:366–75. 26372770, 10.1016/j.psyneuen.2015.08.019CrossRefPubMed Entringer S, Buss C, Wadhwa PD. Prenatal stress, development, health and disease risk: a psychobiological perspective-2015 Curt Richter Award Paper. Psychoneuroendocrinology. 2015;62:366–75. 26372770, 10.1016/j.psyneuen.2015.08.019CrossRefPubMed
9.
go back to reference Wadhwa PD, Culhane JF, Rauh V, Barve SS. Stress and preterm birth: neuroendocrine, immune/inflammatory, and vascular mechanisms. Matern Child Health J. 2001;5:119–25. 11573837, 1:STN:280:DC%2BD3MrislCruw%3D%3D, 10.1023/A:1011353216619CrossRefPubMed Wadhwa PD, Culhane JF, Rauh V, Barve SS. Stress and preterm birth: neuroendocrine, immune/inflammatory, and vascular mechanisms. Matern Child Health J. 2001;5:119–25. 11573837, 1:STN:280:DC%2BD3MrislCruw%3D%3D, 10.1023/A:1011353216619CrossRefPubMed
10.
go back to reference Hoirisch-Clapauch S, Brenner B, Nardi AE. Adverse obstetric and neonatal outcomes in women with mental disorders. Thromb Res. 2015;135. Hoirisch-Clapauch S, Brenner B, Nardi AE. Adverse obstetric and neonatal outcomes in women with mental disorders. Thromb Res. 2015;135.
11.
go back to reference 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. 25765470, 10.1016/j.wombi.2015.02.003CrossRefPubMed 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. 25765470, 10.1016/j.wombi.2015.02.003CrossRefPubMed
12.
go back to reference Christian LM. Effects of stress and depression on inflammatory immune parameters in pregnancy. Am J Obstet Gynecol. 2014;211:275–7. 24956551, 1:CAS:528:DC%2BC2cXhs1KltbbN, 4159131, 10.1016/j.ajog.2014.06.042CrossRefPubMedPubMedCentral Christian LM. Effects of stress and depression on inflammatory immune parameters in pregnancy. Am J Obstet Gynecol. 2014;211:275–7. 24956551, 1:CAS:528:DC%2BC2cXhs1KltbbN, 4159131, 10.1016/j.ajog.2014.06.042CrossRefPubMedPubMedCentral
13.
go back to reference Glover V. Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms. Adv Neurobiol. 2015;10:269–83. 25287545, 10.1007/978-1-4939-1372-5_13CrossRefPubMed Glover V. Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms. Adv Neurobiol. 2015;10:269–83. 25287545, 10.1007/978-1-4939-1372-5_13CrossRefPubMed
14.
go back to reference 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. 21450106, 3080815, 10.1186/1471-2458-11-196CrossRefPubMedPubMedCentral 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. 21450106, 3080815, 10.1186/1471-2458-11-196CrossRefPubMedPubMedCentral
15.
go back to reference 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. 10.1016/j.ajog.2012.06.033CrossRef 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. 10.1016/j.ajog.2012.06.033CrossRef
16.
go back to reference 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;5:557–66. 10.1176/appi.ajp.2008.08081170CrossRef 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;5:557–66. 10.1176/appi.ajp.2008.08081170CrossRef
17.
go back to reference 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. 10.4088/JCP.12r07968CrossRef 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. 10.4088/JCP.12r07968CrossRef
Metadata
Title
Effect of maternal stress during pregnancy on the risk for preterm birth
Authors
Caroline Lilliecreutz
Johanna Larén
Gunilla Sydsjö
Ann Josefsson
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0775-x

Other articles of this Issue 1/2016

BMC Pregnancy and Childbirth 1/2016 Go to the issue