Background

Stressful life events as important stressors have gradually been recognized as the potential etiology that may lead to adverse birth outcomes such as preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). However, researches on this topic have shown relatively inconsistent results. This systematic review and meta-analysis was performed to synthesize available data on the association between prenatal stressful life events and increased risks of PTB, LBW, and SGA.

Methods

Electronic databases were searched from their inception until September 2020. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated to assess the association between prenatal stressful life events and PTB, LBW, and SGA using random effects models. In addition, subgroup analyses, cumulative meta-analyses, sensitivity analyses, and publication bias diagnosis were conducted. STATA 14.0 was applied for statistical analyses.

Results

Totally 31 cohort studies involving 5,665,998 pregnant women were included. Prenatal stressful life events were associated with a 20% higher risk of PTB (RR = 1.20, 95%CI = 1.10-1.32), a 23% increased risk for LBW (RR = 1.23, 95%CI = 1.10-1.39), and a 14% higher risk of SGA (RR = 1.14, 95%CI = 1.08-1.20). Sensitivity analysis indicated the results were stable.

Conclusions

Findings indicated that pregnant women experiencing prenatal stressful life events were at increased risk of PTB, LBW, and SGA. This information provided additional supports that pregnant women experiencing prenatal stressful life events would benefit from receiving assessment and management in prenatal care services.

中文翻译：

---

产前压力性生活事件对不良出生结局的影响：系统评价和荟萃分析

背景

作为重要压力源的紧张生活事件已逐渐被认为是可能导致不良出生结局的潜在病因，例如早产（PTB），低出生体重（LBW）和小胎龄（SGA）。但是，有关该主题的研究显示出相对不一致的结果。进行了系统的综述和荟萃分析，以综合有关产前应激性生活事件与PTB，LBW和SGA风险增加之间的关联的可用数据。

方法

从开始到2020年9月，都对电子数据库进行了搜索。计算了相对风险（RRs）和95％置信区间（CIs），以使用随机效应模型评估产前应激性生活事件与PTB，LBW和SGA之间的关联。此外，还进行了亚组分析，累积荟萃分析，敏感性分析和出版物偏倚诊断。将STATA 14.0用于统计分析。

结果

总共包括31项队列研究，涉及5,665,998名孕妇。产前应激性生活事件与PTB风险增加20％（RR = 1.20，95％CI = 1.10-1.32），LBW风险增加23％（RR = 1.23，95％CI = 1.10-1.39）和SGA风险增加14％（RR = 1.14，95％CI = 1.08-1.20）。敏感性分析表明结果是稳定的。

结论

结果表明，经历产前应激性生活事件的孕妇患PTB，LBW和SGA的风险增加。这些信息提供了额外的支持，使经历产前紧张生活事件的孕妇将从产前保健服务的评估和管理中受益。