title: Antenatal maternal emotional distress and duration of pregnancy.
abstract: OBJECTIVE
  We sought to prospectively study the association between antenatal emotional distress and gestational length at birth as well as preterm birth.
  
  
  METHODS
  We followed up 40,077 primiparous women in the Norwegian Mother and Child Cohort Study. Emotional distress was reported in a short form of the Hopkins Symptom Checklist-25 (SCL-5) at 17 and 30 weeks of gestation. Gestational length at birth, obtained from the Medical Birth Registry of Norway, was used as continuous (gestational length in days) and categorized (early preterm (22-31 weeks) and late preterm (32-36 weeks) versus term birth (≥ 37 weeks)) outcome, using linear and logistic regression analysis, respectively. Births were divided into spontaneous and provider-initiated.
  
  
  RESULTS
  Of all women, 7.4% reported emotional distress at 17 weeks, 6.0% at 30 weeks and 5.1% had a preterm birth. All measurements of emotional distress at 30 weeks were significantly associated with a reduction of gestational length, in days, for provider-initiated births at term. Emotional distress at 30 weeks showed a reduced duration of pregnancy at birth of 2.40 days for provider-initiated births at term. An increase in emotional distress from 17 to 30 weeks was associated with a reduction of gestational length at birth of 2.13 days for provider-initiated births at term. Sustained high emotional distress was associated with a reduction of gestational length at birth of 2.82 days for provider-initiated births. Emotional distress did not increase the risk of either early or late preterm birth.
  
  
  CONCLUSIONS
  Emotional distress at 30 weeks, an increase in emotional distress from 17 to 30 weeks and sustained high levels of emotional distress were associated with a reduction in gestational length in days for provider-initiated term birth. We found no significant association between emotional distress and the risk of preterm birth.
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Department of Health, Nutrition and Management, Oslo and Akershus university college of applied sciences, Oslo, Norway.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Lukasse
authors.affiliation: Norwegian Resource Centre for Women's Health, Oslo University Hospital, Oslo, Norway; Department of Obstetrics, Oslo University Hospital, Oslo, Norway.
authors.forename: Anne
authors.initials: A
authors.lastname: Helbig
authors.affiliation: Institute of Clinical Medicine, Campus Ahus, University of Oslo, and Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Jūratė Šaltytė
authors.initials: JŠ
authors.lastname: Benth
authors.affiliation: Division of Mental Health, Norwegian Institute of Public Health, and Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Malin
authors.initials: M
authors.lastname: Eberhard-Gran
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004644:Emotions; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000523:psychology*; D047928:Premature Birth / Q000523:psychology; D011446:Prospective Studies; D012306:Risk; D013315:Stress, Psychological; D013997:Time Factors; D055815:Young Adult