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Timing of Prenatal Maternal Exposure to Severe Life Events and Adverse Pregnancy Outcomes

A Population Study of 2.6 Million Pregnancies

Bibliographic Data

ID19309552
AuthorsQuetzal A Class (0000-0002-3897-1318, Indiana University Bloomington, corresponding author), Paul Lichtenstein (0000-0003-3037-5287), Niklas Långström (0000-0002-2686-6799), Brian M D’onofrio (0000-0002-5248-7434), Brian M D'Onofrio
Year2011
Volume73
Issue3
Pages234-241
Publication date2011-04-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0b013e31820a62ce
PMID21321257
PMCIDPMC3070756
OpenAlexW2009573448
LanguageEN
Citations received21
References cited43

OBJECTIVE: To identify the impact of timing of prenatal stress exposure on offspring risk for shortened gestational age, preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA), using a population-based sample. METHODS: Swedish longitudinal population registries were linked to study all individuals born in Sweden from 1973 to 2004. Prenatal maternal stress exposure was defined as death of the father of the child or first-degree relative of the mother. Using linear and logistic regression, timing of stress exposure was examined across pregnancy, by month, and by novel periods created based on month of stress exposure findings. RESULTS: A total of 2,618,777 live-born, singleton infants without congenital anomalies were included; 32,286 were exposed to prenatal maternal stress. Examining associations between stress exposure and outcome by the month revealed that risk increases midgestation, particularly after months 5 and 6. Combining months 1 to 4, 5 and 6, and 7 to 9 as potential periods of differing vulnerability, it was found that stress during period 2 (months 5 and 6) was associated with the greatest risk for shortened gestational age (-0.52 days, standard error = 0.15, p = .0006), PTB (odds ratio [OR], 1.24; 99% confidence interval [CI], 1.08-1.42), LBW (OR, 1.38; 99% CI, 1.19-1.61), and SGA (OR, 1.25; 99% CI, 1.05-1.49). CONCLUSIONS: Risk for shortened GA, PTB, LBW, and SGA are greater post stress exposure during the 5th and/or 6th month of pregnancy. It may be beneficial to refine future analyses to these months. Possible mechanisms include alterations in the hypothalamic-pituitary-adrenal axis and associated stress-responsive molecular regulators

Adverse effect · Environmental health · Obstetrics · Population · Pregnancy · Birth, Development, and Health · Internal Medicine · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Stress Responses and Cortisol

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Unique citing works21
Citations per year0.95
Citation span2004 - 2025 (22)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 20

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