462: Effects of periconception and current stress on perinatal outcomes: A Grady Trauma Project study

Abstract

Chronic and acute stress increases risk of pregnancy complications and long-term health problems in pregnant women. This study seeks to identify how stress may affect preterm birth. We leveraged subjects recruited as part of Grady Trauma Project (GTP), an ongoing study of trauma exposure and its consequences in an urban, low-income population. Patients were eligible if they completed initial GTP surveys regarding lifetime trauma exposure and symptoms during pregnancy and delivered at Grady Memorial Hospital. Depression symptoms were assessed using the Beck Depression Inventory (BDI). Perceived current stress was assessed using the Perceived Stress Scale (PSS). Prenatal and delivery records, including admissions for preterm labor and preterm birth were abstracted (n=269). We determined associations between survey scores and preterm labor and delivery using linear regressions. Participants were African-American women with average age of 26.1 years. The majority (71.8%) had the equivalent of a high school diploma or less. 59% of women were considered high risk for pregnancy complications.. 14% were hospitalized for preterm labor. The preterm delivery rate was 16.8% Average BDI sore was 14.58. Average PSS score was 12.0. When controlling for age and parity, those with higher BDI scores had lower rates of hospitalization for preterm labor (t=-2.01, p=0.044) and preterm delivery (t=-2.18, p=0.030). Those with higher PSS scores had lower rates of preterm birth (t=-2.06, p=0.031). Women with higher levels of perceived stress and depression were less likely to be hospitalized for preterm labor and to deliver prematurely. These findings are surprising given previous studies have shown an increase in preterm birth with high levels of stress. Our study is unique in its use of the BDI and PSS in an African-American, low socioeconomic status population with a known high trauma burden. While these differences may represent under-reporting of symptoms, it is plausible that there is an associated biologic compensatory mechanism in the setting of pregnancy and high stress. Further studies are needed to explore the possible mechanisms behind these observed differences.