Kiran Shaikh|Shahirose Premji|Michael Rose|Ambreen Kazi|Shaneela Khowaja|Suzanne Tough
The association between parity, infant gender, higher level of paternal education and preterm birth in Pakistan: a cohort study
Aga Khan University|University of Calgary|Alberta Health Services|Aga Khan University Hospital|Aga Khan University|University of Calgary
abstract background high rates antenatal depression preterm birth reported pakistan self reported maternal stress depression associated preterm birth however findings inconsistent cortisol biological marker stress depression measurement may assist understanding influence self reported maternal stress depression preterm birth methods prospective cohort study pregnant women 28 30 weeks gestation aga khan hospital women children completed az stress scale centre epidemiology studies depression scale assess stress depression respectively blood cortisol level drawn women followed delivery determine birth outcomes correlation coefficients wilcoxon rank sum test used assess relationship preterm birth stress depression cortisol logistic regression analysis used determine key factors predictive preterm birth results 132 pregnant women participated 125 pregnant women questionnaire cortisol level data additional seven questionnaire data almost 20 pregnant women 197 95 ci 133275 experienced high level stress nearly twice many 409 95 ci 324498 experienced depressive symptoms median cortisol level 2740 ugdl iqr 225342 preterm birth rate 114 95 ci 6518 relationship cortisol values stress scale depression significant positive relationship maternal depression stress preterm birth associated higher parity past delivery male infant higher levels paternal education insufficient numbers preterm births available warrant development multivariable logistic regression model conclusions preterm birth associated higher parity past delivery male infant higher levels paternal education relationship stress depression cortisol preterm birth high rates stress depression among sample suggesting missed opportunities address mental health needs prenatal period improved methods measurement required better understand psychobiological basis preterm birth