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Prenatal Stress and Risk of Spontaneous Abortion

Wainstock, Tamar MMedSc; Lerner-Geva, Liat PhD, MD; Glasser, Saralee MA; Shoham-Vardi, Ilana PhD; Anteby, Eyal Y. MD

doi: 10.1097/PSY.0b013e318280f5f3
Original Articles

Objective The aim of this study was to evaluate the association between exposure to life-threatening rocket attacks and spontaneous abortions (SAs).

Study Design This is a historical cohort study comparing 1345 pregnancies of female residents of a town exposed to rocket attacks with 2143 pregnancies of female residents of an unexposed town. Demographic and medical data were obtained from hospital records and exposure information from official local databases. Intensity of exposure was calculated for preconception and pregnancy periods.

Results Compared with unexposed group, women in the exposed group had higher rates of SA (6.9% versus 4.7%, adjusted odds ratio = 1.59, 95% confidence interval = 1.17–2.2, p = .003). Intensity of preconception and pregnancy exposure were nonlinearly associated with SA risk; both the highest and the lowest quintiles of exposure were associated with increased risk of SA.

Conclusions Stress during preconception and pregnancy was associated with increased risk of SA.

From the Departments of Epidemiology, Faculty of Health Sciences (T.W., I.S.-V.), Ben Gurion University of the Negev, Beer-Sheva, Israel; Obstetrics and Gynecology (E.Y.A.), Barzilai Medical Center, Ashkelon, Israel; Women and Children’s Health Research Unit (L.L.-G., S.G.), Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel; School of Public Health, Sackler Faculty of Medicine (L.L.-G.), Tel Aviv University, Tel Aviv, Israel.

Address correspondence and reprint requests to Tamar Wainstock, MMedSc, Department of Epidemiology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva 84105, Israel. E-mail:

Received for publication May 9, 2012; revision received November 21, 2012.

Copyright © 2013 by American Psychosomatic Society
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