ArticleBMC pregnancy and childbirth2011
The association between parity, infant gender, higher level of paternal education and preterm birth in Pakistan: a cohort study.
Article in BMC pregnancy and childbirth, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- The association between maternal cortisol and depression during pregnancy, a systematic review.Archives of women's mental health · 2018Pooled it
- Prenatal depression and adverse birth outcomes: an updated systematic review.Maternal and child health journal · 2015Pooled it
- Prevalence and risk factors of perinatal depression among mothers and fathers in Pakistan: a systematic review and meta-analysis.Health psychology and behavioral medicine · 2024Review
- Preterm Birth Among Intrapartum Cesarean Deliveries at Public Hospitals in Southern Ethiopia: A Multicenter Retrospective Analysis of Risk Factors.International journal of women's health · 2023Article
- Individual and collective contribution of antenatal psychosocial distress conditions and preterm birth in Pakistani women.PloS one · 2023Article
- Paternal factors and adverse birth outcomes in Lanzhou, China.BMC pregnancy and childbirth · 2021Article
- Maternal anaemia and risk of adverse obstetric and neonatal outcomes in South Asian countries: A systematic review and meta-analysis.Public health in practice (Oxford, England) · 2020Review
- Maternal autonomy and high-risk pregnancy in Bangladesh: the mediating influences of childbearing practices and antenatal care.BMC pregnancy and childbirth · 2020Article
- Prenatal stress and child development: A scoping review of research in low- and middle-income countries.PloS one · 2018Article
- Barefoot therapists: barriers and facilitators to delivering maternal mental health care through peer volunteers in Pakistan: a qualitative study.International journal of mental health systems · 2016Article
- The effect of parity on maternal body mass index, plasma mineral element status and new-born anthropometrics.African health sciences · 2015Article
- Paternal factors associated with neonatal deaths and births with low weight: evidence from Pakistan Demographic and Health Survey 2006-2007.Maternal and child health journal · 2015Article
- Psychobiobehavioral Model for Preterm Birth in Pregnant Women in Low- and Middle-Income Countries.BioMed research international · 2015Review
- Perinatal distress in women in low- and middle-income countries: allostatic load as a framework to examine the effect of perinatal distress on preterm birth and infant health.Maternal and child health journal · 2014Review
- Preterm delivery and psycho-social determinants of health based on World Health Organization model in Iran: a narrative review.Global journal of health science · 2012Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh rates of antenatal depression and preterm birth have been reported in Pakistan. Self reported maternal stress and depression have been associated with preterm birth; however findings are inconsistent. Cortisol is a biological marker of stress and depression, and its measurement may assist in understanding the influence of self reported maternal stress and depression on preterm birth.
methodsIn a prospective cohort study pregnant women between 28 to 30 weeks of gestation from the Aga Khan Hospital for Women and Children completed the A-Z Stress Scale and the Centre for Epidemiology Studies Depression Scale to assess stress and depression respectively, and had a blood cortisol level drawn. Women were followed up after delivery to determine birth outcomes. Correlation coefficients and Wilcoxon rank sum test was used to assess relationship between preterm birth, stress, depression and cortisol. Logistic regression analysis was used to determine the key factors predictive of preterm birth.
results132 pregnant women participated of whom 125 pregnant women had both questionnaire and cortisol level data and an additional seven had questionnaire data only. Almost 20% of pregnant women (19·7%, 95% CI 13·3-27·5) experienced a high level of stress and nearly twice as many (40·9%, 95% CI 32·4-49·8%) experienced depressive symptoms. The median of cortisol level was 27·40 ug/dl (IQR 22·5-34·2). The preterm birth rate was 11·4% (95% CI 6·5-18). There was no relationship between cortisol values and stress scale or depression. There was a significant positive relationship between maternal depression and stress. Preterm birth was associated with higher parity, past delivery of a male infant, and higher levels of paternal education. Insufficient numbers of preterm births were available to warrant the development of a multivariable logistic regression model.
conclusionsPreterm birth was associated with higher parity, past delivery of a male infant, and higher levels of paternal education. There was no relationship between stress, and depression, cortisol and preterm birth. There were high rates of stress and depression among this sample suggesting that there are missed opportunities to address mental health needs in the prenatal period. Improved methods of measurement are required to better understand the psychobiological basis of preterm birth.
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