Risk of Spontaneous Preterm Birth in Relation to Maternal Depressive, Anxiety, and Stress Symptoms
To examine the risk of preterm birth (PTB) in relation to maternal psychiatric symptoms during pregnancy in Peruvian women. This case-control study included 479 PTB cases and 480 term controls. In-person interviews were conducted to assess women's depressive, anxiety, and stress symptoms using the Patient Health Questionnaire (PHQ-9) and the Depression Anxiety Stress Scales (DASS-21). Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Compared with women reporting no or minimal depressive symptoms, the aOR (95% CI) for PTB associated with consecutive severity of depressive symptoms based on the PHQ-9 assessment method were as follows: mild, 2.22 (95% CI 1.64-3.00) and moderate-severe, 3.67 (95% CI 2.09-6.46). The corresponding aORs for normal, mild, and moderate-severe depressive symptoms based on the DASS-21 assessment were 1.00 (reference), 3.82 (95% CI 1.90-7.66), and 2.90 (95% CI 1.66-5.04), respectively. A positive gradient was observed for the odds of PTB with severity of anxiety (Ptrend < 0.001) and stress symptoms (Ptrend < 0.001). The odds of PTB increased in pregnant Peruvian women with psychiatric symptoms. Efforts to screen and treat affected women may modify risks of PTB and possibly other associated disorders.