Evidence map›Paper›PMID 40877810›Full record

ArticleBMC pregnancy and childbirth2025

The impact of maternal chronic stress on spontaneous preterm birth: evidence from a Chinese cohort study.

Xu Zhou, Liuxiao Zhang, Xiang Hong, Chen Zhang, Dongyan Qiao, Yan Xuan, Hong Yu, Bei Wang

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Xu ZhouDepartment of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
Liuxiao ZhangDepartment of Obstetrics and Gynecology, Medical School, Southeast University, Nanjing, Jiangsu, China.
Xiang HongDepartment of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
Chen ZhangCenter of Clinical Laboratory Medicine, Medical School, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China.
Dongyan QiaoDepartment of Obstetrics and Gynecology, Medical School, Southeast University, Nanjing, Jiangsu, China.
Yan XuanDepartment of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
Hong YuDepartment of Obstetrics and Gynecology, Medical School, Southeast University, Nanjing, Jiangsu, China.
Bei WangDepartment of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China. wangbeilxb@163.com.

Funding

National Natural Science Foundation of China 82473643
6 · The paper itself

Abstract

backgroundThis study aimed to examine the relationship between maternal chronic stress, measured as allostatic load (AL), and the subsequent risk of spontaneous preterm birth (sPTB).

methodsThis analysis was based on a prospective, single-center cohort study conducted in China. Eligible women were recruited during their second trimester and followed up until giving birth. AL was estimated at enrollment by using 10 biomarkers that reflect cardiovascular, metabolic, immune, and neuroendocrine dysregulation. High AL group was defined as women with AL score greater than the upper sample quartile. Latent class analysis (LCA) was performed to identify underlying AL patterns among pregnant women. Logistic regressions were employed to test the association between AL and sPTB. Additionally, the dose-response associations between AL score and sPTB were evaluated by using a 3-knot restricted cubic spline (RCS).

results637 pregnant women with a mean AL score of 2.6 ± 1.7 (mean ± SD) were included in this study. Among these participants, 175 (27.5%) were classified into the high AL group (AL score ≥ 4). The sPTB rate was 6.6%. After adjusting for sociodemographic and clinical factors, multivariable logistic regression analysis revealed a significant positive association between AL score and sPTB (OR = 1.28, 95% CI: 1.07-1.52, P = 0.007). Similarly, women in the high AL group had significantly higher sPTB risk compared with those in the low AL group (OR = 2.09, 95% CI: 1.08-3.99, P = 0.025). LCA yielded three AL latent classes: (1) low dysregulation class, (2) metabolic-immune dysregulation class, and (3) cardiovascular dysregulation class. When compared with the low dysregulation class, the metabolic-immune dysregulation class was significantly associated with sPTB (OR = 2.60, 95% CI: 1.18-5.49, P = 0.014). RCS showed there was an obvious dose-dependent association between increased AL score and risk of sPTB.

conclusionsThis study provides evidence that AL during pregnancy is associated with the risk of sPTB, especially the metabolic-immune dysregulation class of AL. Evaluating AL and chronic stress during pregnancy may be potential tools to identify pregnant women at high risk of sPTB. Further work is needed to validate these findings in larger or diverse populations.

Indexed as

AllostasisPregnancy ComplicationsPremature BirthStress, PsychologicalAdultBiomarkersChinaCohort StudiesEast Asian PeopleFemaleHumansLogistic ModelsPregnancyProspective StudiesRisk FactorsBiomarkersAllostatic loadChronic stressLatent class analysisRestricted cubic splineSpontaneous preterm birth

Identifiers

PMID40877810
PMCPMC12392516

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.