Meta-Analysis of the Effect of Prenatal Stress on the Premature Birth

Irfa Nur Faujiah, Bhisma Murti, Hanung Prasetya


Background: Premature birth is a major global public health problem, especially in developing countries. One of the causes of this incident is exposure to psychological stress experienced during pregnancy. This study aims to estimate the magnitude of the effect of prenatal stress on preterm birth using a meta-analysis study.

Subjects and Method: The meta-analysis research was conducted by selecting articles published in the years 2006-2020, from the PubMed, Google Scholar, Science Direct, Direc­tory of Open Access (DOAJ), and Springer Link databases. The article search was carried out by considering the eligibility criteria defined using the PICO model. The population in the study were pregnant women with high stress prenatal intervention, comparison with low stress and preterm birth outcomes. This article was collected for 1 month using the following key­words: "Prenatal Stress" AND "Preterm Birth". The inclusion criteria were a free full text study, using English and Indonesian, high stress preg­nant women, observational studies, and the results were reported in the Adjusted Odds Ratio (aOR). The meta-analysis study was carried out with the Review Manager 5.3 program.

Results: Meta-analysis of 10 cohort studies showed that pregnant women with high stress were at risk for preterm birth (aOR = 1.35; 95% CI = 1.05 to 1.73; p = 0.02), and 4 case-control studies showed that pregnant women with high stress had a risk for preterm birth (aOR = 2.00; 95% CI = 0.61 to 6.50; p = 0.25).

Conclusion: Prenatal stress has a risk of preterm birth.

Keywords: Pregnant women, prenatal stress, preterm birth, meta-analysis

Correspondence: Irfa Nur Faujiah. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: Mobile: +6282127200347.

Journal of Maternal and Child Health (2020), 05(06): 601-613


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Cardwell MS (2017). Stress: pregnancy con siderations. Pediatr Emerg Care, 33 (12): 792–793. doi: 10.1097/01.pec. 0000526609.89886.37.

Center for Evidence-Based Management. (2005). Critical appraisal of a survey appraisal questions. (10): 12.

Critical Appraisal Skills Programme (2018). CASP checklist: cohort study. Casp Uk. on August 2020.

Dunkel-Schetter C (2004). Stress and pre-term delivery. J Psychosom Obstet Gynaecol, 25(1): 1–2. doi: 10.1080/0-1674820410001737388.

Eick SM, Meeker JD, Swartzendruber A, McConnell RR, Brown P, Velez-Vega C, Shen Y, et al. (2020). Relationships between psychosocial factors during pregnancy and preterm birth in Puer to Rico. PLoS ONE, 15(1): 1–14. doi: 10.1371/journal.pone.0227976.

Glynn LM, Hobel CJ, Schetter CD, Sand-man CA (2008). Pattern of perceived stress and anxiety in pregnancy pre-dicts preterm birth. J Health Psychol, 27(1): 43–51. doi: 10.1037/0278-613-

Gokoel AR, Zijlmans WCWR, Covert HH, Wahid FA, Shankar A, MacDonald Ottevanger MS, Hindori Mohangoo AD, et al. (2020). Influence of pre-natal exposure to mercury, perceived stress, and depression on birth out-comes in suriname: Results from the mekitamara study. Int J Environ Res Public Health, 17(12): 1–14. doi: 10.3390/ijerph17124444.

Grobman WA, Parker CB, Willinger M, Wing DA, Silver RM, Wapner RJ, Simhan HN, et al. (2018). Racial disparities in adverse pregnancy out-comes and psychosocial stress. AOG, 131(2): 328–335. doi: 10.1097/AOG.0000000000002441.

Khashan AS, Everard C, McCowan LME, Dekker, G, Moss-Morris R, Baker, PN, Poston L, et al. (2014). Second-trimester maternal distress increases the risk of small for gestational age. Psy chol Med. 44(13): 2799–2810. doi: 10.1017/S0033291714000300.

Murti B (2018). Prinsip dan Metode Riset Epidemiologi (Epidemiological Rese-arch Principles and Methods). 5th edn. Surakarta: Program Studi Ilmu Kesehatan Masyarakat, Program Pas-casarjana, Universitas Sebelas Maret.

Shapiro GD, Fraser WD, Frasch MG, Seguin JR (2013). Psychosocial stress in pregnancy and preterm birth: Asso ciations and mechanisms. J Perinat Med, 41(6): 631–645. doi: 10.1515/ jpm-2012-0295.

Tanpradit K, Kaewkiattikun K (2020). The effect of perceived stress during pregnancy on preterm birth. Int J Wo-men's Health. 12: 287–293. doi: 10.2147/IJWH.S239138.

Vidal AC, Neelon SEB, Liu Y, Tuli AM, Fuemmeler BF, Hoyo C, Murtha AP, et al. (2014). Maternal stress, preterm birth, and DNA methylation at imprint regulatory sequences in hu-mans. Genet Epigenetics. 1(6): 37–44. doi: 10.4137/GEG.S18067.

Wadhwa P, Culhane JF, Rauh V, Barve SS, Hogan V, Sandman CA, Hobel CJ, et al. (2001). Stress, infection and pre-term birth: a biobehavioural perspective. Wiley Online Library. 15(2): 17–29. doi: j. 13-65-3016.2001.00005.x.

Wainstock T, Shoham Vardi I, Glasser S, Anteby E, Lerner-Geva L (2014). Fetal sex modifies effects of prenatal stress exposure and adverse birth out-comes’, Stress. Informa Healthcare, 18(1): 49–56. doi: 10.3109/1-0253890 .2014.974153.


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