title: Preterm delivery in Boston before and after September 11th, 2001.
abstract: BACKGROUND
  We hypothesized that stress induced by the terrorist attacks of September 11, 2001 might shorten pregnancy. To test this hypothesis, we compared gestational duration and risk of preterm delivery among women who were pregnant on September 11 with women who had delivered before that date.
  
  
  METHODS
  We conducted a matched cohort study among pregnant women enrolled in the Boston-based cohort study Project Viva between 1999 and 2001. Each of 606 participants, pregnant on September 11, 2001, was matched to 1 or 2 participants who delivered before that date.
  
  
  RESULTS
  Compared with women who delivered before September 11th, women who were pregnant on September 11th had mean gestation length that was 0.13 weeks longer (95% confidence interval = -0.05 to 0.30) and an odds ratio for preterm delivery before 37 weeks' gestation of 0.60 (0.36 to 0.98). Only women exposed in the first trimester had longer gestation.
  
  
  CONCLUSIONS
  Contrary to expectation, Boston-area women who were pregnant on September 11th had a lower risk of preterm delivery than women who delivered before that date. Although the interpretation of this finding is difficult, it is clear that the acute psychologic stress documented nationwide after the terrorist attacks did not increase the risk of preterm delivery in this population at some distance from the attacks.
authors.affiliation: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, Boston, MA 02215, USA. janet_rich-edwards@hphc.org
authors.forename: Janet W
authors.initials: JW
authors.lastname: Rich-Edwards
authors.forename: Ken P
authors.initials: KP
authors.lastname: Kleinman
authors.forename: Emily F
authors.initials: EF
authors.lastname: Strong
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
mesh_terms: D000328:Adult; D001900:Boston / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*