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Cumulative life stressors and stress response to threatened preterm labour as birth date predictors

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Preterm birth represents one of the main causes of neonatal morbimortality and a risk factor for neurodevelopmental disorders. Appropriate predictive methods for preterm birth outcome, which consequently would facilitate prevention programs, are needed. We aim to predict birth date in women with a threatened preterm labour (TPL) based on stress response to TPL diagnosis, cumulative life stressors, and relevant obstetric variables.

Methods

A prospective cohort of 157 pregnant women with TPL diagnosis between 24 and 31 weeks gestation formed the study sample. To estimate the stress response to TPL, maternal salivary cortisol, α-amylase levels, along with anxiety and depression symptoms were measured. To determine cumulative life stressors, previous traumas, social support, and family functioning were registered. Then, linear regression models were used to examine the effect of potential predictors of birth date.

Results

Lower family adaptation, higher Body Mass Index (BMI), higher cortisol levels and TPL diagnosis week were the main predictors of birth date. Gestational week at TPL diagnosis showed a non-linear interaction with cortisol levels: TPL women with middle- and high-cortisol levels before 29 weeks of gestation went into imminent labour.

Conclusion

A combination of stress response to TPL diagnosis (salivary cortisol) and cumulative life stressors (family adaptation) together with obstetric factors (TPL gestational week and BMI) was the best birth date predictor. Therefore, a psychosocial therapeutic intervention program aimed to increase family adaptation and decrease cortisol levels at TPL diagnosis as well as losing weight, may prevent preterm birth in symptomatic women.

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Collected data and materials of assessment comply with field standards and are available if required.

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Acknowledgements

We are greatly indebted to all the pregnant women, their families, nursing, and medical staff who voluntarily participated in the present study. Without their collaboration and enthusiasm, this study could not have been completed.

Funding

Prior to study initiation, a grant was awarded by the Instituto de Salud Carlos III (PI18/01352). To achieve this grant, the project was assessed by an external peer review panel, guaranteeing scientific quality and ethical integrity. MV acknowledges PI17/0131 grant from the Instituto de Salud Carlos III (Spanish Ministry of Economy and Competitiveness) (ISCIII; Plan Estatal de I + D + I 2013–2016) and co-financed by the European Development Regional Fund “A way to achieve Europe” (ERDF); and RETICS funded by the PN 2018–2011 (Spain), ISCIII- Sub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (FEDER), RD16/0022/0001.VD acknowledges PI18/01352 grant from the ISCIII. CC-P acknowledges a “Miguel Servet I” grant (CP16/00082) from the ISCIII. AG-B acknowledges a “Juan Rodés” grant (JR17/00003) and a health research project (PI18/01352) from the ISCIII. LC-B acknowledges a “Río Hortega” grant (CM20/00143) from the ISCIII.

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Authors and Affiliations

  1. Neonatal Research Unit, Health Research Institute La Fe, Av Fernando Abril Martorell, 106, 46026, Valencia, Spain

    Laura Campos-Berga, Alba Moreno-Giménez, Máximo Vento, Pilar Sáenz, Consuelo Cháfer-Pericás & Ana García-Blanco

  2. Division of Obstetrics and Gynecology, University and Polytechnic Hospital La Fe, Valencia, Spain

    Vicente Diago

  3. Data Science Unit, Biostatistics, and Bioinformatics, Health Research Institute La Fe, Valencia, Spain

    David Hervás

  4. Polytechnic University of Valencia, Valencia, Spain

    David Hervás

  5. Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, Valencia, Spain

    Ana García-Blanco

Authors
  1. Laura Campos-Berga
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  2. Alba Moreno-Giménez
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  3. Máximo Vento
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  4. Vicente Diago
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  5. David Hervás
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  7. Consuelo Cháfer-Pericás
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  8. Ana García-Blanco
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Contributions

MV: protocol/project development; funding acquisition; supervision; manuscript writing/editing. AM-G: data collection; manuscript writing/editing. LC-B: data collection; manuscript writing/editing. VD: protocol/project development; funding acquisition; supervision; manuscript writing/editing. DH: data analysis; software; manuscript writing. PS: protocol/project development; data collection; manuscript writing/editing. CC: protocol/project development; data analysis; manuscript writing/editing. AG-B: protocol/project development; funding acquisition; data collection; supervision; manuscript writing/editing.

Corresponding author

Correspondence to Ana García-Blanco.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The Ethics Committee at the La Fe Health Research Institute approved the study protocol in 2015 (ref. 2015/0086) and informed consent was obtained from all participants.

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Campos-Berga, L., Moreno-Giménez, A., Vento, M. et al. Cumulative life stressors and stress response to threatened preterm labour as birth date predictors. Arch Gynecol Obstet 305, 1421–1429 (2022). https://doi.org/10.1007/s00404-021-06251-z

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