Maternal prenatal stress and its effects on primary pregnancy outcomes in twin pregnancies

Abstract

Objective: To assess the prevalence and degrees of maternal prenatal stress among twin-pregnant women and to investigate the impact of prenatal stress on primary pregnancy outcomes.

Methods: The Chongqing Longitudinal Twin Study (LoTiS) began in December 2015 in China. Participants of LoTiS who met the inclusion criteria were recruited into this study and completed a stress rating scale (PSRS) in both early and late pregnancy. Maternal prenatal stress was examined in subgroups. Correlations between maternal prenatal stress and primary pregnancy outcomes were analyzed by multivariate logistic regression.

Results: A total of 215 eligible twin pregnancies from LoTiS were recruited into this study. The overall mean scores of prenatal stress were 43.41 ± 19.84 and 51.33 ± 20.43 in early and late pregnancy, respectively. The first prenatal stressor was regarding concern about the pregnancy and childbirth safety. Subgroup analyses revealed prenatal stress in late pregnancy that differed based on different pregravid BMIs and education levels. Correlation analysis suggested that the risk of preterm premature rupture of membranes increases 1.8% per unit of stress scale in late pregnancy (OR = 1.018, 95% CI 1.001–1.025).

Conclusions: Prenatal stress in twin pregnancies increases with the progression of pregnancy. Higher stress in late pregnancy is associated with a higher risk of premature rupture of membranes; therefore, interventions might be essential for improving pregnancy outcomes.

Keywords:

• Twin pregnancies
• prenatal stress
• pregnancy outcomes
• cohort study

Acknowledgment

The authors would like to acknowledge the support from the National Base for Innovation and Talent Introduction in Maternal andFetal Medicine (111 program).

Ethical approval

Ethical approval to conduct the study was provided by the Medical Ethics Committee of The First Affiliated Hospital of Chongqing Medical University, and the study complies with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by grants from the Ministry of Science and Technology [2018YFC1002901, 2016YFC1000407], the National Natural Sciences Foundation of China [81520108013, 81671488, 81771613, and 81871189], Chongqing Municipal Education Commission [CXTDX201601014], and Chongqing Entrepreneurship and Innovation Supporting Program for Returned Overseas Students [cx2017104].