Is maternal stress associated with adverse birth outcomes in rural Mysore, India

Background: Studies have shown an association between stress and increased risk for preterm delivery. There are few measures available to quantify pregnancy-specific stressors among Indian women. A culturally-sensitive instrument was adapted to measure perceived stress among young pregnant women in rural Mysore, India. Method: In 2009, a prospective cohort study was conducted in Mysore district among 985 young pregnant women. Women were assessed for socio-demographic, economic status as well as for perceived stress using a culturally adapted A-Z Stress scale (Kazi et al, 2009). Sexual history, and clinical examination were conducted and women were followed up after delivery. Statistical analysis was conducted using SPSS v17. Results: High levels of pregnancy-specific stressors were identified. Among 985 participants, 41% had delivered low birth weight infants and 12% had experienced preterm births. About 21% of women were identified as experiencing significant stress based on stress scale. There was significant positive correlation between: total stress score and low birth weight in previous delivery (Spearman rho= 0.152, p<0.0001), diagnosis of an STD and preterm delivery (Spearman rho=0.095, p<0.05). There was also significant positive correlation between having a previous low birth-weight infant and having a low birth-weight infant (Spearman rho= 0.109, p<0.05). The odds for preterm delivery among stressed women was not significant (OR=1.16). Stress and preterm delivery were also associated with Education level household income and personal income. Conclusion: Pregnant women in rural Mysore experience high levels of perceived stress. Future analysis will look at the relationship of stress during pregnancy with adverse birth outcomes.