TY - JOUR
T1 - A prospective cohort study on changes in psychosocial distress and preterm birth among pregnant Pakistani women
AU - Sulaiman, Salima
AU - Dosani, Aliyah
AU - Yim, Ilona S.
AU - Lalani, Sharifa
AU - Forcheh, Ntonghanwah
AU - Premji, Shahirose Sadrudin
N1 - Publisher Copyright:
© 2025 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/
PY - 2025/12
Y1 - 2025/12
N2 - Changes in mental health during pregnancy may better predict preterm birth (PTB) as assessment at one time point are inconsistently associated with this outcome. Our prospective cohort study of 1225 pregnant Pakistani women determined whether (a) changes in psychosocial distress (i.e., pregnancy-related anxiety, state anxiety, depressive symptoms) between 10 and 19 and 22 to 29 weeks’ gestational age influenced the risk of PTB; and (b) social determinants of health and chronic stress influenced this relationship. The individual effect of changes in (a) pregnancy-related anxiety on PTB was significant only among women with low social support from family (OR = 0.85, 95 % CI 0.74–0.97, p = 0.017); and (b) depressive symptoms on PTB were significantly modified by education (p = 0.011), number of previous children (p = 0.028) and life-time interpersonal trauma (p = 0.073). The average aggregate change score was associated with PTB among women with low family support (OR = 0.79, 95 % CI 0.67–0.93, p = 0.005), after adjusting for confounders. The collective effect, assessed using multiple logistic regression, was not significant. Chronic stress did not alter any findings. An intersectional approach will enable exploration of the disparate burden of psychosocial distress during pregnancy on PTB.
AB - Changes in mental health during pregnancy may better predict preterm birth (PTB) as assessment at one time point are inconsistently associated with this outcome. Our prospective cohort study of 1225 pregnant Pakistani women determined whether (a) changes in psychosocial distress (i.e., pregnancy-related anxiety, state anxiety, depressive symptoms) between 10 and 19 and 22 to 29 weeks’ gestational age influenced the risk of PTB; and (b) social determinants of health and chronic stress influenced this relationship. The individual effect of changes in (a) pregnancy-related anxiety on PTB was significant only among women with low social support from family (OR = 0.85, 95 % CI 0.74–0.97, p = 0.017); and (b) depressive symptoms on PTB were significantly modified by education (p = 0.011), number of previous children (p = 0.028) and life-time interpersonal trauma (p = 0.073). The average aggregate change score was associated with PTB among women with low family support (OR = 0.79, 95 % CI 0.67–0.93, p = 0.005), after adjusting for confounders. The collective effect, assessed using multiple logistic regression, was not significant. Chronic stress did not alter any findings. An intersectional approach will enable exploration of the disparate burden of psychosocial distress during pregnancy on PTB.
KW - Anxiety
KW - Depression
KW - Lower-middle-income country
KW - MiGHT
KW - Pregnancy
KW - Premature birth
UR - https://www.scopus.com/pages/publications/105024780517
U2 - 10.1016/j.jadr.2025.100964
DO - 10.1016/j.jadr.2025.100964
M3 - Article
AN - SCOPUS:105024780517
SN - 0941-9500
VL - 22
JO - Journal of Affective Disorders Reports
JF - Journal of Affective Disorders Reports
M1 - 100964
ER -
