title: Risk of spontaneous preterm birth in relation to maternal experience of serious life events during pregnancy.
abstract: BACKGROUND
  The purpose of this study was to examine the risk of preterm birth (PTB) in relation to serious life events experienced during pregnancy in Peruvian women.
  
  
  METHODS
  This case-control study included 479 PTB cases and 480 term controls. In-person interviews asked information regarding sociodemographics, medical and reproductive histories, and serious life events experienced during pregnancy. Multivariate logistic regression procedures were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  Compared with women who did not experience a serious life event during pregnancy, those who experienced the following life events had a more than two-fold increased odds of PTB: death of first-degree relative (adjusted OR 2.10; 95% CI 1.38-3.20), divorce or separation (adjusted OR 2.09; 95% CI 1.10-4.00), financial troubles (adjusted OR 2.70; 95% CI 1.85-3.94), or serious fight with partner (adjusted OR 2.40; 95% CI 1.78-3.17). Women who experienced any serious life events during pregnancy had higher odds (adjusted OR 2.29; 95% CI 1.65-3.18) of suffering spontaneous preterm labor and preterm premature rupture of membranes (adjusted OR 2.19; 95% CI 1.56-3.08), compared with women who did not experience any such events. Associations of similar directions and extent were observed for severity of PTB (ie, very, moderate, or late PTB). The magnitude of the associations increased as increased frequency of serious life events (P trend <0.001).
  
  
  CONCLUSIONS
  Experiencing serious life events during pregnancy was associated with increased odds of PTB among Peruvian women. Interventions aimed at assisting women experiencing serious life events may reduce the risk of PTB. Future studies should include objective measures of stress and stress response to understand better the biological underpinnings of these associations.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Yasmin V
authors.initials: YV
authors.lastname: Barrios
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Dos de Mayo, Lima, Peru ; Universidad Nacional Mayor de San Marco, Lima, Peru.
authors.forename: Sixto E
authors.initials: SE
authors.lastname: Sanchez
authors.affiliation: Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA.
authors.forename: Chunfang
authors.initials: C
authors.lastname: Qiu
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Bizu
authors.initials: B
authors.lastname: Gelaye
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
keywords: Peru; preterm birth; serious life events