Risk of spontaneous preterm birth in relation to maternal experience of serious life events during pregnancy

Abstract

BackgroundThe purpose of this study was to examine the risk of preterm birth (PTB) in relation to serious life events experienced during pregnancy in Peruvian women.MethodsThis case-control study included 479 PTB cases and 480 term controls. In-person interviews asked information regarding sociodemographics, medical and reproductive histories, and serious life events experienced during pregnancy. Multivariate logistic regression procedures were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).ResultsCompared with women who did not experience a serious life event during pregnancy, those who experienced the following life events had a more than two-fold increased odds of PTB: death of first-degree relative (adjusted OR 2.10; 95% CI 1.38–3.20), divorce or separation (adjusted OR 2.09; 95% CI 1.10–4.00), financial troubles (adjusted OR 2.70; 95% CI 1.85–3.94), or serious fight with partner (adjusted OR 2.40; 95% CI 1.78–3.17). Women who experienced any serious life events during pregnancy had higher odds (adjusted OR 2.29; 95% CI 1.65–3.18) of suffering spontaneous preterm labor and preterm premature rupture of membranes (adjusted OR 2.19; 95% CI 1.56–3.08), compared with women who did not experience any such events. Associations of similar directions and extent were observed for severity of PTB (ie, very, moderate, or late PTB). The magnitude of the associations increased as increased frequency of serious life events (Ptrend <0.001).ConclusionExperiencing serious life events during pregnancy was associated with increased odds of PTB among Peruvian women. Interventions aimed at assisting women experiencing serious life events may reduce the risk of PTB. Future studies should include objective measures of stress and stress response to understand better the biological underpinnings of these associations.

Prenatal Stress, Prematurity, and Asthma

“…The relation between prenatal stress and prematurity is complex and likely influenced by timing and degree of maternal perceived stress, type of stressor [20] [21] and maternal coping mechanisms, and maternal race or ethnicity. For example, exposure to an earthquake (a traumatic event) has been associated with preterm birth only when such exposure occurred during the first trimester of pregnancy [22].…”

<p>The Effect of Perceived Stress During Pregnancy on Preterm Birth</p>

“…A report from Peru revealed that prenatal serious life events caused more than a twofold increased risk of preterm birth (OR 2.29, 95% CI 1.65-3.18) and the magnitude of the association increased with the increased frequency of serious life events (p trend , 0.001). 23 Another report from China revealed that risk of preterm birth increased with higher prenatal serious life events during the first trimester (OR 2.40, 95% CI 1.13-5.09) and second trimester (OR 2.86, 95% CI 1.26-6.47). 18 The reason for different findings in this study may be that the impact of stressful life events varies depending on lifestyle, culture, intent of stressor, timing of stressor, and self-perceived stress.…”

Withholding Information to Protect a Loved One

“…1,2 But this possibility is relevant only insofar as the difference in outcomes of birth at 28 and 30 weeks is significant. Are the increased risks associated with being born at 28 weeks versus 30 weeks sufficiently weighty to override the presumption that we must tell the mother?…”