Psychosocial stress during pregnancy and perinatal outcomes: a meta-analytic review

Abstract

The objective of this study was to evaluate the relationship between psychosocial stress in pregnancy and negative perinatal outcomes and to identify key moderators of this relationship. To evaluate this relationship, a meta-analytic review was conducted of studies that prospectively assessed the relationship between psychosocial stress in pregnancy and perinatal outcomes. A total of 35 studies, written or published between 1991 and 2009, involving 31,323 women were located. The overall association between psychosocial stress and negative perinatal outcomes was significant, but negligibly small in size (r (35) = -0.04, CI = -0.08, -0.01). Examining specific perinatal outcomes, only the associations with neonatal weight (r (14) = -0.07, CI = -0.03, -0.01) and risk for low birth weight (r (5) = 0.07, CI = 0.03, 0.10) were statistically significant, but again, very small. Results support that psychosocial stress explains a negligible to very small amount of the variability in perinatal outcomes. Future research should focus on identifying other psychosocial and lifestyle variables that alone or in interaction with other factors explain larger amounts of the variability in perinatal outcomes. Future research should also examine whether psychosocial stress increases risk for negative outcomes in combination with other biomedical and psychosocial risk factors.

Allostatic Load in Women with a History of Low Birth Weight Infants: The National Health and Nutrition Examination Survey

“…Prior studies using subjective assessments of stress have found associations between stress and anxiety during pregnancy and perinatal outcomes. [25][26][27][28] Our findings using AL score as an objective measure of chronic stress are consistent with those findings. AL conceptually captures the ''cost'' of adaptation to stressors.…”

Is the economic crisis affecting birth outcome in Spain? Evaluation of temporal trend in underweight at birth (2003–2012)

“…Recent reviews examining, at the aggregate-level, the effects of psychosocial stress on the risk of negative perinatal outcomes (low birth weight and preterm deliveries) generated results that remain inconclusive due to methodological discrepancies (Catalano et al, 2011;Littleton et al, 2010;Zilko, 2010). Nevertheless, individual-level studies have documented the association between birth outcomes and maternal psychological stress, ranging from chronic anxiety and depressive symptoms to acute stressors, and determined by both pregnancy-specific and general life event anxiety (Mulder et al, 2002;Torche, 2011).…”

The influence of maternal cortisol and emotional state during pregnancy on fetal intrauterine growth

“…In humans, results of research investigating the relationship between maternal distress and lower birth weight are inconsistent (9)(10)(11)(12)(13)(14). Although there is evidence that maternal stress during pregnancy can lead to slower fetal growth, the variance explained by maternal stress is very low, i.e., about 1% in a meta-analysis of 35 studies (15).…”