Adverse childhood experiences are associated with spontaneous preterm birth: a case–control study

BMC Medicine

David M Olson¹  Kathleen Hegadoren²  Inge Christiaens³ 

[1] Departments of Obstetrics and Gynecology, Pediatrics and Physiology, University of Alberta, Edmonton T6G 2S2, Alberta, Canada;Faculty of Nursing, University of Alberta, Edmonton T6G 2S2, Alberta, Canada;Department of Obstetrics and Gynaecology, Newcastle University, Newcastle upon Tyne NE2 4HH, UK

关键词: Preterm birth;    Maternal stress;    Adverse childhood experiences;   

Others  :  1213729
DOI  :  10.1186/s12916-015-0353-0

 received in 2015-01-28, accepted in 2015-04-24,  发布年份 2015

【 摘 要 】

Background

More than 1 in 10 infants are born prematurely worldwide, making preterm birth the leading cause of neonatal mortality and morbidity. Chronic maternal stress is increasingly recognized as one of the contributing risk factors for preterm birth, yet its specific role remains largely unknown. Examining the exposure to stressors over a mother’s life course might provide more perspective on the role of maternal stress in preterm birth. Our aim was therefore to retrospectively explore the associations between chronic, lifelong stressors and protective factors and spontaneous preterm birth.

Methods

This study was part of a large case–control study based in Edmonton, Canada, examining gene-environment interactions and preterm birth. Cases were mothers with a spontaneous singleton preterm birth (<37 weeks) without preterm premature rupture of membranes. Controls were mothers with an uncomplicated singleton term birth without a history of preterm birth. Sociodemographic and medical data were collected. A postpartum telephone questionnaire was administered to assess stressors across the lifespan. Both individual and contextual variables that could influence stress response systems were examined. Overall, 622 women were included, of which 223 subjects – 75 cases and 148 controls – completed the stress questionnaire. Univariate and multivariate logistic regression analyses were performed.

Results

Multivariate analysis showed that exposure to two or more adverse childhood experiences (ACEs) was associated with a two-fold risk of preterm birth, regardless of maternal age, smoking status, educational status, and history of miscarriage (adjusted OR, 2.09; 95 % CI, 1.10–3.98; P = 0.024). The adjusted odds ratio for the ACE score was 1.18 (95 % CI, 0.99–1.40), suggesting that for every increase in childhood adverse event endorsed, the risk of preterm birth increased by 18 %. Lifetime physical and emotional abuse was also associated with spontaneous preterm birth in our study population (adjusted OR, 1.30; 95 % CI, 1.02–1.65; P = 0.033).

Conclusions

A strong relationship between ACEs and preterm birth was observed. It has been shown that two or more ACEs have a notable two-fold increase in the risk of spontaneous preterm birth. These data demonstrate that stressors throughout life can have a significant effect on pregnancy outcomes such as preterm birth.

【 授权许可】

   
2015 Christiaens et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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