Article, 2024
Stress and anxiety during pregnancy and length of gestation: a federated study using data from five Canadian and European birth cohorts
European Journal of Epidemiology,
ISSN
1573-7284,
0393-2990,
Pages 1-11,
10.1007/s10654-024-01126-4
Contributors
Bergeron, Julie
0000-0003-4772-4332
(Corresponding author)
[1]
[2]
Avraam, Demetris
0000-0001-8908-2441
[3]
Calas, Lucinda
0000-0003-1144-4320
[4]
Fraser, William Donald
[5]
Harris, Jennifer R.
[6]
Heude, Barbara
0000-0002-1565-1629
[4]
Mandhane, Piush J
0000-0003-3682-9120
[7]
Moraes, Theo J.
[8]
Muckle, Gina
0000-0001-9632-5755
[9]
Nader, Johanna Lucia Thorbjørnsrud
0000-0002-2045-1269
[6]
Séguin, Jean Richard
0000-0003-3359-6202
[10]
Simons, Elinor
[11]
Subbarao, Padmaja
[8]
Swertz, Morris A
0000-0002-0979-3401
[12]
[13]
Tough, Suzanne Carol
0000-0001-5583-7404
[14]
Turvey, Stuart Eric
0000-0003-1599-1065
[15]
[16]
Fortier, Isabel
0000-0001-8207-3059
[1]
Rod, Naja Hulvej
0000-0002-6400-5105
[2]
Andersen, Anne-Marie Nybo
0000-0002-4296-8488
[2]
Affiliations
- [1]
McGill University Health Centre
[NORA names:
Canada; America, North; OECD];
- [2]
University of Copenhagen
[NORA names:
KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD];
- [3]
Newcastle University
[NORA names:
United Kingdom; Europe, Non-EU; OECD];
- [4]
Centre of Research in Epidemiology and Statistics
[NORA names:
France; Europe, EU; OECD];
- [5]
Université de Sherbrooke
[NORA names:
Canada; America, North; OECD];
(... more)
- [6]
Norwegian Institute of Public Health
[NORA names:
Norway; Europe, Non-EU; Nordic; OECD];
- [7]
University of Alberta
[NORA names:
Canada; America, North; OECD];
- [8]
University of Toronto
[NORA names:
Canada; America, North; OECD];
- [9]
Université Laval
[NORA names:
Canada; America, North; OECD];
- [10]
University of Montreal
[NORA names:
Canada; America, North; OECD];
- [11]
University of Manitoba
[NORA names:
Canada; America, North; OECD];
- [12]
University Medical Center Groningen
[NORA names:
Netherlands; Europe, EU; OECD];
- [13]
University of Groningen
[NORA names:
Netherlands; Europe, EU; OECD];
- [14]
University of Calgary
[NORA names:
Canada; America, North; OECD];
- [15]
British Columbia Children's Hospital
[NORA names:
Canada; America, North; OECD];
- [16]
University of British Columbia
[NORA names:
Canada; America, North; OECD]
(less)
Abstract
While its etiology is not fully elucidated, preterm birth represents a major public health concern as it is the leading cause of child mortality and morbidity. Stress is one of the most common perinatal conditions and may increase the risk of preterm birth. In this paper we aimed to investigate the association of maternal perceived stress and anxiety with length of gestation. We used harmonized data from five birth cohorts from Canada, France, and Norway. A total of 5297 pregnancies of singletons were included in the analysis of perceived stress and gestational duration, and 55,775 pregnancies for anxiety. Federated analyses were performed through the DataSHIELD platform using Cox regression models within intervals of gestational age. The models were fit for each cohort separately, and the cohort-specific results were combined using random effects study-level meta-analysis. Moderate and high levels of perceived stress during pregnancy were associated with a shorter length of gestation in the very/moderately preterm interval [moderate: hazard ratio (HR) 1.92 (95%CI 0.83, 4.48); high: 2.04 (95%CI 0.77, 5.37)], albeit not statistically significant. No association was found for the other intervals. Anxiety was associated with gestational duration in the very/moderately preterm interval [1.66 (95%CI 1.32, 2.08)], and in the early term interval [1.15 (95%CI 1.08, 1.23)]. Our findings suggest that perceived stress and anxiety are associated with an increased risk of earlier birth, but only in the earliest gestational ages. We also found an association in the early term period for anxiety, but the result was only driven by the largest cohort, which collected information the latest in pregnancy. This raised a potential issue of reverse causality as anxiety later in pregnancy could be due to concerns about early signs of a possible preterm birth.
Keywords
Canada,
Cox,
Cox regression models,
DataSHIELD platform,
European birth cohorts,
France,
Norway,
age,
analysis,
anxiety,
associated with gestational duration,
association,
birth,
birth cohort,
causality,
child mortality,
children,
cohort,
cohort-specific results,
concerns,
conditions,
data,
duration,
early signs,
early term period,
etiology,
federal studies,
federated analysis,
findings,
gestation,
gestational age,
gestational duration,
harmonized data,
health concern,
increased risk,
information,
interval,
intervals of gestational age,
issue of reverse causality,
issues,
length,
length of gestation,
levels,
levels of perceived stress,
meta-analysis,
model,
morbidity,
mortality,
perceived stress,
perinatal conditions,
period,
platform,
pregnancy,
preterm,
preterm birth,
public health concern,
regression models,
results,
reverse causality,
risk,
risk of preterm birth,
shorter length,
shorter length of gestation,
signs,
singleton,
stress,
study,
study-level meta-analysis,
term period
Funders
Data Provider: Digital Science