Maternal stress during pregnancy and gestational duration: A cohort study from the Danish National Birth Cohort

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Background: Preterm birth is one of the most important contributors to neonatal mortality and morbidity. Experiencing stress during pregnancy may increase the risk of adverse birth outcomes, including preterm birth. This association has been observed in previous studies, but differences in measures used limit comparability. Objective: The objective of the study was to investigate the association between two measures of maternal stress during pregnancy, life stress and emotional distress, and gestation duration. Methods: Women recruited in the Danish National Birth Cohort from 1996 to 2002, who provided information on their stress level during pregnancy and expecting a singleton baby, were included in the study. We assessed the associations between the level of life stress and emotional distress in quartiles, both collected at 31 weeks of pregnancy on average, and the rate of giving birth using Cox regression within intervals of the gestational period. Results: A total of 80,991 pregnancies were included. Women reporting moderate or high levels of life stress vs no stress had a higher rate of giving birth earlier within all intervals of gestational age (e.g. high level: 27–33 weeks: hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.04, 1.84; 34–36 weeks: 1.10, 95% CI 0.97, 1.25; 37–38 weeks: 1.21, 95% CI 1.15, 1.28). These associations between life stress and preterm birth were mainly driven by pregnancy worries. For emotional distress, a high level of distress was associated with shorter length of gestation in the preterm (27–33 weeks: 1.38, 95% CI 1.02, 1.86; 34–36 weeks: 1.05, 95% CI 0.91, 1.19) and early term (1.11, 95% CI 1.04, 1.17) intervals. Conclusions: Emotional distress and life stress were shown to be associated with gestational age at birth, with pregnancy-related stress being the single stressor driving the association. This suggests that reverse causality may, at least in parts, explain the earlier findings of stress as a risk factor for preterm birth.

TidsskriftPaediatric and Perinatal Epidemiology
Udgave nummer1
Sider (fra-til)45-56
Antal sider12
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This study was supported by the Research Advancement through Cohort Cataloguing and Harmonisation initiative (Canadian Institutes of Health Research, OCR‐144561) and the EUCAN‐connect, a federated FAIR platform enabling large‐scale analysis of high‐value cohort data connecting Europe and Canada in personalised health project (European Commission, Grant Agreement No 824989).

Funding Information:
The Danish National Birth Cohort was established with a significant grant from the Danish National Research Foundation. Additional support was obtained from the Danish Regional Committees, the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Health Foundation and other minor grants. The DNBC Biobank has been supported by the Novo Nordisk Foundation and the Lundbeck Foundation. Follow‐up of mothers and children have been supported by the Danish Medical Research Council (SSVF 0646, 271‐08‐0839/06‐066023, O602‐01042B, 0602‐02738B), the Lundbeck Foundation (195/04, R100‐A9193), The Innovation Fund Denmark 0603‐00294B (09‐067124), the Nordea Foundation (02‐2013‐2014), Aarhus Ideas (AU R9‐A959‐13‐S804), University of Copenhagen Strategic Grant (IFSV 2012), and the Danish Council for Independent Research (DFF – 4183‐00594 and DFF ‐ 4183‐00152).

Publisher Copyright:
© 2022 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.

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