BackgroundPreterm birth defined as birth prior to 37 weeks of gestation is caused by different risk factors and implies an increased risk for disease and early death for the child. The aim of the study was to investigate the effect of maternal stress during pregnancy on the risk of preterm birth.MethodsA case–control study that included 340 women; 168 women who gave birth preterm and 172 women who gave birth at term. Data were manually extracted from standardized medical records. If the medical record contained a psychiatric diagnosis or a self-reported stressor e.g., depression or anxiety the woman was considered to have been exposed to stress during pregnancy.Adjusted odds ratio (AOR) was used to calculate the attributable risk (AR) of maternal stress during pregnancy on preterm birth, both for the women exposed to stress during pregnancy (AR1 = (AOR-1)/AOR) and for the whole study population (AR2 = AR1*case fraction).ResultsMaternal stress during pregnancy was more common among women who gave birth preterm compared to women who gave birth at term (p <0.000, AOR 2.15 (CI = 1.18–3.92)). Among the women who experienced stress during pregnancy 54 % gave birth preterm with stress as an attributable risk factor. Among all of the women the percentage was 23 %.ConclusionsStress seems to increase the risk of preterm birth. It is of great importance to identify and possibly alleviate the exposure to stress during pregnancy and by doing so try to decrease the preterm birth rate.
ObjectiveTo compare psychiatric in- and outpatient care during the 5 years before first delivery in primiparae delivered by caesarean section on maternal request with all other primiparae women who had given birth during the same time period.DesignProspective, population-based register study.SettingSweden.SampleWomen giving birth for the first time between 2002 and 2004 (n = 64 834).MethodsWomen giving birth by caesarean section on maternal request (n = 1009) were compared with all other women giving birth (n = 63 825). The exposure of interest was any psychiatric diagnosis according to the International Statistical Classification of Diseases and Related Health Problems (ninth revision, ICD–9, 290–319; tenth revision, ICD–10, F00–F99) in The Swedish national patient register during the 5 years before first delivery.Main outcome measuresPsychiatric diagnoses and delivery data.ResultsThe burden of psychiatric illnesses was significantly higher in women giving birth by caesarean section on maternal request (10 versus 3.5%, P < 0.001). The most common diagnoses were ‘Neurotic disorders, stress-related disorders and somatoform disorders’ (5.9%, aOR 3.1, 95% CI 1.1–2.9), and ‘Mood disorders’ (3.4%, aOR 2.4, 95% CI 1.7–3.6). The adjusted odds ratio for caesarean section on maternal request was 2.5 (95% CI 2.0–3.2) for any psychiatric disorder. Women giving birth by caesarean section on maternal request were older, used tobacco more often, had a lower educational level, higher body mass index, were more often married, unemployed, and their parents were more often born outside of Scandinavia (P < 0.05).ConclusionsWomen giving birth by caesarean section on maternal request more often have a severe psychiatric disease burden. This finding points to the need for psychological support for these women as well as the need to screen and treat psychiatric illness in pregnant women.
BackgroundTo study pregnancy and delivery outcomes in nulliparous women with severe FOC (fear of childbirth), all of whom had received routine treatment for their FOC and to make comparisons with a healthy reference group of nulliparous women.To study the possible relationship between the number of FOC-treatment sessions and the delivery method.MethodsAll nulliparous women with a diagnose FOC who received routine treatment for FOC (n = 181) and a reference group of nulliparous women without FOC (n = 431) at a university and a county hospital in the south east region of Sweden were analysed. Data from antenatal and delivery medical records were used to study outcome.ResultsThe majority of women with severe FOC had a vaginal delivery. The incidence of elective CS was greater in the index group than in the reference group (p < 0.001). The total number of women with a planned CS in the index group was 35 (19.4%) and in the control group 14 (3.2%). Thus, on average five women per year received an elective CS during the study years due to severe FOC. The women in the index group who wished to have a CS were similar to the other women in the index group with reference to age, BMI, chronic disease but had been in in-patient care more often during their pregnancy than those who did not ask for CS (p = 0.009).ConclusionIn this study of women treated for severe FOC, the majority gave birth vaginally and no relationship was found between number of treatment sessions and mode of childbirth.
Methods: Thirty pregnant women with blood-and injection phobia according to DSM-IV took part in an open treatment intervention. A two-session cognitive behavior group therapy was conducted. As controls, 46 pregnant women with untreated blood-and injection phobia and 70 healthy pregnant women were used. Repeated measures ANOVA were performed. Results:The scores for the CBT treatment group on the "Injection Phobia Scale-Anxiety"were reduced both after each treatment session and postpartum (p<0.001). Anxiety and depressive symptoms were also reduced (p<0.001). Conclusion:Cognitive-behavior group therapy for pregnant women with blood-and injection phobia is effective and stable up to at least 3 months postpartum. It seems also to reduce anxiety and depressive symptoms during pregnancy.
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