June 16th, 2019

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Risk of Spontaneous Preterm Birth in Relation to Maternal Depressive, Anxiety, and Stress Symptoms
Authors:  Sixto E. Sanchez, M.D., M.P.H., Gabriella C. Puente, B.S., Guillermo Atencio, M.D., Chungfang Qiu, M.D., M.S., David Yanez, Ph.D., Bizu Gelaye, M.P.H., and Michelle A. Williams, Sc.D.
  OBJECTIVE: To examine the risk of preterm birth (PTB) in relation to maternal psychiatric symptoms during pregnancy in Peruvian women.

STUDY DESIGN: This case-control study included 479 PTB cases and 480 term controls. In-person interviews were conducted to assess women’s depressive, anxiety, and stress symptoms using the Patient Health Questionnaire (PHQ-9) and the Depression Anxiety Stress Scales (DASS-21). Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

RESULTS: Compared with women reporting no or minimal depressive symptoms, the aOR (95% CI) for PTB associated with consecutive severity of depressive symptoms based on the PHQ-9 assessment method were as follows: mild, 2.22 (95% CI 1.64–3.00) and moderate-severe, 3.67 (95% CI 2.09–6.46). The corresponding aORs for normal, mild, and moderate-severe depressive symptoms based on the DASS-21 assessment were 1.00 (reference), 3.82 (95% CI 1.90–7.66), and 2.90 (95% CI 1.66–5.04), respectively. A positive gradient was observed for the odds of PTB with severity of anxiety (ptrend <0.001) and stress symptoms (ptrend <0.001).

CONCLUSION: The odds of PTB increased in pregnant Peruvian women with psychiatric symptoms. Efforts to screen and treat affected women may modify risks of PTB and possibly other associated disorders.
Keywords:  anxiety, depressive symptoms, preterm birth, psychological stress
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