The relationship between prenatal psychological stress and placental abruption in Japan, The Japan Environment and Children's Study (JECS).

Yasuyuki Kawanishi,Yoshiya Ito,Toshinobu Miyamoto,Toshihiro Itoh,Reiko Kishi,Kazuo Sengoku,Toshiaki Endo,Eiji Yoshioka,Chihiro Miyashita,Kazutoshi Cho,Atsuko Araki,Sachiko Ito,Yasuaki Saijo,Hisanori Minakami,Kenji Hashimoto

doi:10.1371/journal.pone.0219379

Abstract

BackgroundPrenatal psychological stress may increase the risk of placental abruption (PA). This study aimed to clarify the effects of psychological distress during pregnancy and exposure to stressful life events in the year before or during pregnancy on the occurrence of PA in Japanese women.MethodsUsing a nationwide prospective birth cohort study, we obtained data from 103,099 women between January 2011 and March 2014. Information on exposure to 14 stressful life events and psychological distress (Kessler 6 scale) was collected using a self-administered questionnaire during pregnancy. Clinical diagnoses of PA were obtained from medical records. A total of 80,799 women with singleton births were analyzed using logistic regression models that adjusted for possible confounders.ResultsPA was diagnosed in 335 (0.4%) women. There was no significant difference in the Kessler 6 score during pregnancy between the PA group and non-PA group. Exposure to the death of a child in the year before or during pregnancy was significantly associated with PA in multigravid women (adjusted odds ratio [aOR] 3.57; 95% confidence interval [CI] 1.50–8.34). A spouse’s loss of employment was significantly associated with PA in parous women (aOR 3.25; 95% CI 1.40–7.56).ConclusionsThis study identified the possible effects of exposure to the death of a child on PA occurrence that adjusted for important confounding factors.

Highlights

Placental abruption (PA) is a severe condition involving the partial or complete separation of a normally implanted placenta before delivery, and occurs in 0.4–1% of all pregnancies [1, 2]
Exposure to the death of a child in the year before or during pregnancy was significantly associated with placental abruption (PA) in multigravid women
This study identified the possible effects of exposure to the death of a child on PA occurrence that adjusted for important confounding factors

Summary

Introduction

Placental abruption (PA) is a severe condition involving the partial or complete separation of a normally implanted placenta before delivery, and occurs in 0.4–1% of all pregnancies [1, 2]. This condition is one of the most important causes of maternal morbidity and perinatal mortality [1,2,3]. Previous studies have reported that psychologically stressed pregnant women are at increased risk of intrauterine growth restriction (IUGR) [6, 7], pre-eclampsia [8], and PA [9, 10]. This study aimed to clarify the effects of psychological distress during pregnancy and exposure to stressful life events in the year before or during pregnancy on the occurrence of PA in Japanese women

Objectives

Methods

Conclusion