Stress Pathways to Spontaneous Preterm Birth: The Role of Stressors, Psychological Distress, and Stress Hormones
Référence bibliographique 
Kramer, Michael S., Lydon, John, Seguin, Louise, Goulet, Lise, Kahn, Susan R., McNamara, Helen, Genest, Jacques, Dassa, Clément, Chen, Moy Fong, Sharma, Shakti, Meaney, Michael J., Thomson, Steven, Van Uum, Stan, Koren, Gideon, Dahhou, Mourad, Lamoureux, Julie et Platt, Robert W. 2009. «Stress Pathways to Spontaneous Preterm Birth: The Role of Stressors, Psychological Distress, and Stress Hormones ». American Journal of Epidemiology, vol. 169, no 11, p. 1319-1326.
Intentions : « Preterm birth is the leading cause of infant mortality in industrialized societies. Despite several decades of intensive investigation, an understanding of its etiologic determinants has proved elusive, and few effective preventive interventions have been identified. In fact, rates of preterm birth continue to rise throughout the developed world. » (p. 1319) In this paper, the authors contribute to the understanding of preterm birth etiology, through the investigation of various potential factors of preterm birth.
Échantillon/Matériau : 5,337 Montreal-area women who delivered from October 1999 to April 2004
Type de traitement des données : Analyse statistique
« The authors investigated a large number of stressors and measures of psychological distress in a multicenter, prospective cohort study of spontaneous preterm birth. [...] Among the large number of stress and distress measures studied, only pregnancy-related anxiety was consistently and independently associated with spontaneous preterm birth [...]. The maternal plasma CRH concentration was significantly higher in cases than in controls in crude analyses but not after adjustment [...]. [...] Neither maternal plasma CRH, hair cortisol, nor placental histopathologic features of infection/inflammation, infarction, or maternal vasculopathy were significantly associated with pregnancy-related anxiety or any other stress or distress measure. The biologic pathways underlying stress-induced preterm birth remain poorly understood. » (p. 1319) « The role of stressors, psychological distress, and stress hormones in causing preterm birth remains elusive. [...] In our view, an informed assessment of stress and stress pathways leading to preterm birth will require a better understanding of the basic biology underlying the onset of labor, both in the preterm period and at term. » (p. 1324)