Reducing maternal stress can improve maternal and neonatal health outcomes; Study
A new study published in the BJOG: An International Journal of Obstetric and Gynecology showed that recurrent preterm birth was more than three times as common in women whose stress levels remained high or increased later in pregnancy.
The likelihood of unfavourable neonatal and pediatric outcomes, like respiratory distress and neurodevelopmental problems, is increased by preterm birth (PTB). Maternal salivary cortisol levels and PTB continue to have a complicated connection. Thus, this study examined the relationship between salivary cortisol, prenatal mother perceived stress, and the likelihood of recurrent preterm birth (rPTB).
245 pregnant women having a history of spontaneous singleton PTB, all of whom were now bearing singleton pregnancies were included. Online self-completed computerized REDCap surveys and a summary of computerized medical records containing information on prescription drugs, test findings, and salivary cortisol were the data sources.
During their pregnancy, participants gave saliva samples and answered stress questionnaires twice, with four to eight weeks between examinations. Women with high vs low cortisol and perceived stress (>75th percentile) were compared in terms of recurrent PTB incidence. The probabilities of rPTB were analyzed using multivariable logistic regression models.
22.4% of the 245 women had rPTB. After controlling for mother age, the number of previous PTBs, and parity, a greater frequency of rPTB was linked to high felt stress levels later in pregnancy (38.9% vs. 19.2%; p = 0.011, adj. OR = 2.44, 95% CI: 1.053–5.639; p = 0.038). The incidence of rPTB was highest in women who experienced high levels of stress on a regular basis (40%), followed by women who had higher levels of stress later in pregnancy (37.5%).
High stress was consistently shown to be a significant risk factor for rPTB in multivariable regression models (adj. OR = 3.82, 95% CI: 1.37–10.64; p = 0.010) and exclusively in later pregnancy (adj. OR = 3.18, 95% CI: 1.04–9.73; p = 0.042). There was no correlation seen between rPTB, high felt stress during the first trimester, and cortisol levels. Women with and without rPTB did not vary in terms of lifestyle, health, or demographic traits.
There was no correlation seen between rPTB, high felt stress during the first trimester, and cortisol levels. Women with and without rPTB did not vary in terms of lifestyle, health, or demographic traits. Overall, as a modifiable risk factor for recurrent PTB, this study emphasized the critical significance of perceived mother stress throughout late pregnancy.
Reference:
Hagbi Bal, M., Yaniv Salem, S., Sheiner, E., Shoham, I., Yoles, I., Israel-Tov, N. D., Tomasis Damri, N., Bergman, D., Rosenbaum, R., Haimov, A., Baram Goldberg, I., Shoham-Vardi, I., & Wainstock, T. (2025). Breaking the cycle of preterm birth: A prospective cohort study on maternal stress and recurrent preterm birth. BJOG: An International Journal of Obstetrics and Gynaecology, 1471-0528.70064. https://doi.org/10.1111/1471-0528.70064
