STUDY: Don't Stress Out

JOURNAL: American Journal of Epidemiology 2003;157:14-24.

AUTHORS: Dr. Nancy Dole

ABSTRACT: While studies on the effects of stress during pregnancy have yielded conflicting results, the latest report finds that it may raise a woman's risk of premature delivery.

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COMMENTARY: Pregnant women who said they were experiencing high levels of stress from events such as marital separation, problems with in-laws or issues at work were 80% more likely to have a preterm delivery than those who reported low stress levels.

Overall, there were 71 preterm births and 402 full-term births among women reporting high stress, compared with 39 preterm births and 416 full-term births in the low-stress group.

Among those most at risk are women in low socioeconomic groups who may get inadequate prenatal care and have constant worries about critical issues such as paying rent and putting food on the table.

"Stress is a fight-or-flight kind of phenomenon," Heyl said, explaining that pregnant women under stress may have increased steroid secretions in the womb that can stimulate cellular receptors that control uterine contraction and relaxation. "Chronic stress could over-stimulate those receptors," he said.

The new study involved 1,962 pregnant women who were being treated at two prenatal clinics in North Carolina. In addition to their medical exams, the women were instructed to complete and mail in a survey that asked various questions about their psychological state, stressful life events, social support and other issues that might impact their pregnancies.

There's a general feeling that if women recognize the stress in their lives and can do some stress reduction during pregnancy they can change this risk.