Hum. Reprod. Advance Access published online on December 3, 2008
Human Reproduction, doi:10.1093/humrep/den418
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Rates of preterm birth following antenatal maternal exposure to severe life events: a population-based cohort study
1 Centre for Women’s Mental Health, University of Manchester, Manchester, UK 2 Biostatistics Group, University of Manchester, Manchester, UK 3 Maternal and Fetal Health Research Group, University of Manchester, Manchester, UK 4 National Centre for Register-based Research, University of Aarhus, Aarhus, Denmark 5 The Anu Research Center, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork Ireland
6 Correspondence address. Tel: +353-214205031; Fax: +353-214205025; E-mail: a.khashan{at}ucc.ie
BACKGROUND: Preterm birth and other pregnancy complications have been linked to maternal stress during pregnancy. We investigated the association between maternal exposure to severe life events and risk of preterm birth.
METHODS: Mothers of all singleton live births (n = 1.35 million births) in Denmark between 1 January 1979 and 31 December 2002 were linked to data on their children, parents, siblings and partners. We defined exposure as death or serious illness in close relatives in the first or second trimesters or in the 6 months before conception. Log-linear binomial regression was used to estimate the effect of exposure on preterm birth, very preterm birth and extremely preterm birth.
RESULTS: There were 58 626 (4.34%) preterm births (<37 weeks), 11 732 (0.87%) very preterm births and 3288 (0.24%) extremely preterm births in the study cohort. Severe life events in close relatives in the 6 months before conception increased the risk of preterm birth by 16% (relative risk, RR = 1.16, [95% CI: 1.08–1.23]). Severe life events in older children in the 6 months before conception increased the risk of preterm birth by 23% (RR = 1.23, [95% CI: 1.02–1.49]) and the risk of very preterm birth by 59% (RR = 1.59, [95% CI: 1.08–2.35]).
CONCLUSIONS: Our population-based cohort study suggests that maternal exposure to severe life events, particularly in the 6 months before pregnancy, may increase the risk of preterm and very preterm birth.
Key words: preterm birth/maternal stress/pregnancy/severe life events/obstetric complications
Submitted on July 22, 2008; resubmitted on October 11, 2008; accepted on October 15, 2008.
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