Role of anxiety and depression in the onset of spontaneous preterm labor.
The aim of this cohort study conducted in France in 1997-1998 was to investigate the effects of antenatal anxiety and depression on spontaneous preterm labor. A consecutive series of 634 pregnant women with singleton pregnancies was included. Anxiety and depression were assessed using self-administered questionnaires: Spielberger's State-Trait Anxiety Inventory and the Edinburgh depression scale. Depression scores were dichotomized with a cutoff value suggestive of major depression. The 75th percentile was used for anxiety scores. A logistic regression analysis, controlling for sociodemographic and biomedical factors and including interaction terms, revealed that depression was positively associated with the outcome among underweight women, defined as women with a prepregnancy body mass index below 19 (adjusted odds ratio (OR) = 6.9, 95% confidence interval (CI): 1.8, 26.2). A similar result was observed for trait anxiety in women with a history of preterm labor (adjusted OR = 4.8, 95% CI: 1.1, 20.4). The association was close to significance for state anxiety in women with vaginal bleeding (adjusted OR = 3.6, 95% CI: 0.9, 14.7). These findings show that anxiety and depression, when combined with specific biomedical factors, are associated with spontaneous preterm labor. A synergic action of psychological and biomedical factors on the secretion of placental corticotropin-releasing factor is hypothesized.
Dayan
J
J
Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU Clemenceau, Caen, France. dayan-j@chu-caen.fr
Creveuil
C
C
Herlicoviez
M
M
Herbel
C
C
Baranger
E
E
Savoye
C
C
Thouin
A
A
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications*; D015331:Cohort Studies; D003346:Corticotropin-Releasing Hormone / Q000378:metabolism; D003863:Depression / Q000150:complications*; D005260:Female; D006470:Hemorrhage; D006801:Humans; D008875:Middle Aged; D007752:Obstetric Labor, Premature / Q000209:etiology* / Q000523:psychology*; D011247:Pregnancy; D012044:Regression Analysis; D012307:Risk Factors; D014621:Vagina
D003346:Corticotropin-Releasing Hormone