title: Pattern of perceived stress and anxiety in pregnancy predicts preterm birth.
abstract: OBJECTIVE
  To determine whether the pattern of prenatal stress, as compared to prenatal stress assessed at a single gestational time point, predicts preterm delivery (PTD).
  
  
  METHODS
  Perceived stress and anxiety were assessed in 415 pregnant women at 18-20 and 30-32 weeks' gestation.
  
  
  METHODS
  Gestational length was determined by last menstrual period and confirmed by early pregnancy ultrasound. Births were categorized as preterm (< 37 weeks) or term.
  
  
  RESULTS
  At neither assessment did levels of anxiety or perceived stress predict PTD. However, patterns of anxiety and stress were associated with gestational length. Although the majority of women who delivered at term exhibited declines in stress and anxiety, those who delivered preterm exhibited increases. The elevated risk for PTD associated with an increase in stress or anxiety persisted when adjusting statistically for obstetric risk, pregnancy-related anxiety, ethnicity, parity, and prenatal life events.
  
  
  CONCLUSIONS
  These data suggest that the pattern of prenatal stress is an important predictor of PTD. More generally, the findings support the possibility that a decline in stress responses during pregnancy may help to protect mother and fetus from adverse influences associated with PTD.
authors.affiliation: Department of Psychiatry & Human Behavior, University of California, Irvine, Orange 92868, USA. lglynn@uci.edu
authors.forename: Laura M
authors.initials: LM
authors.lastname: Glynn
authors.forename: Christine Dunkel
authors.initials: CD
authors.lastname: Schetter
authors.forename: Calvin J
authors.initials: CJ
authors.lastname: Hobel
authors.forename: Curt A
authors.initials: CA
authors.lastname: Sandman
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000175:diagnosis; D005260:Female; D005865:Gestational Age; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D015141:Los Angeles; D011247:Pregnancy / Q000523:psychology; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology* / Q000523:psychology; D011379:Prognosis; D018570:Risk Assessment; D013315:Stress, Psychological / Q000175:diagnosis; D011795:Surveys and Questionnaires