title: Maternal stress and infant mortality: the importance of the preconception period.
abstract: Although preconception and prenatal maternal stress are associated with adverse outcomes in birth and childhood, their relation to infant mortality remains uncertain. We used logistic regression to study infant mortality risk following maternal stress within a population-based sample of infants born in Sweden between 1973 and 2008 (N = 3,055,361). Preconception (6-0 months before conception) and prenatal (between conception and birth) stress were defined as death of a first-degree relative of the mother. A total of 20,651 offspring were exposed to preconception stress, 26,731 offspring were exposed to prenatal stress, and 8,398 cases of infant mortality were identified. Preconception stress increased the risk of infant mortality independently of measured covariates, and this association was timing specific and robust across low-risk groups. Prenatal stress did not increase risk of infant mortality. These results suggest that the period immediately before conception may be a sensitive developmental period with ramifications for infant mortality risk.
authors: 1Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th St., Bloomington, IN 47405, USA. qaclass@indiana.edu
authors: Quetzal A
authors: QA
authors: Class
authors: Ali S
authors: AS
authors: Khashan
authors: Paul
authors: P
authors: Lichtenstein
authors: Niklas
authors: N
authors: Långström
authors: Brian M
authors: BM
authors: D'Onofrio
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology*; D016742:Preconception Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
keywords: bereavement; health; infant development; infant mortality; maternal stress; preconception; prenatal; stress reactions
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