Effect of psychosocial stress on maternal complications during pregnancy: A cohort study

Aim: To determine the effect of psychosocial stress on maternal complications during pregnancy Methods: A population based prospective cohort study was carried out in Sri Lanka from May 2001 to April 2002. Pregnant women were recruited on or before 16 weeks of gestation and followed up until delivery. The sample size was 774. The relevant exposure data were collected on average during the 12 and 28 week of gestation. Psychosocial stress was assessed using the Modified Life Events Inventory and the General Health Questionnaire 30 (GHQ 30). Maternal complications were defined as the presence of pregnancy induced hypertension or gestational diabetes or ante partum hemorrhage. Multiple logistic regression was applied and the results were expressed as odds ratios (OR) and 95% confidence intervals (95%CI). Results: On multiple logistic regression analysis, experience of ≥2 life events during the second trimester [OR 3.0, 95%CI: 1.19, 7.64], GHQ score >5 during the second trimester [OR 3.24, 95%CI: 1.32, 7.93], body mass index >26.0 kg/m [OR 1.25, 95%CI: 1.31, 9.27], pre pregnancy weight >51 kg [OR 1.23, 95%CI: 1.25, 9.33] and educational level up to grade 5 [OR 1.93, 95%CI: 2.0, 23.41] were risk factors for maternal complications during pregnancy. Conclusions: Psychosocial stress during the second trimester, BMI >26 kg/m, pre pregnancy weight >51kg and low educational level were risk factors for maternal complications during pregnancy.