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Effects of maternal exposure to acute stress on birth outcomes: a quasi-experiment study

Published online by Cambridge University Press:  23 December 2021

Asma Ahmed Open the ORCID record for Asma Ahmed [Opens in a new window] ,
Suzanne King ,
Guillaume Elgbeili ,
David P. Laplante  and
Seungmi Yang
Asma Ahmed
Affiliation:
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
Suzanne King
Affiliation:
Department of Psychiatry, McGill University, Montreal, Quebec, Canada
Guillaume Elgbeili
Affiliation:
Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada
David P. Laplante
Affiliation:
Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada
Seungmi Yang*
Affiliation:
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
*
Address for correspondence: Seungmi Yang, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada. Email: seungmi.yang@mcgill.ca
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Abstract

Numerous studies have shown associations between maternal stress and poor birth outcomes, but evidence is unclear for causal inference. Natural disasters provide an opportunity to study effects of quasi-randomized hardship with an accurate measure of onset and duration. In a population-based quasi-experimental study, we examined the effect of maternal exposure to the January 1998 Québec ice storm on birth outcomes by comparing pregnant mothers who lived in an area hard hit by the ice storm with those in two unaffected regions. In a total of 147,349 singleton births between 1995 and 2001, we used a difference-in-differences method to estimate the effects of the ice storm on gestational age at delivery (GA), preterm birth (PTB), weight-for-gestational-age z-scores (BWZ), large for gestational age (LGA), and small for gestational age (SGA). After adjusting for maternal and sociodemographic characteristics, there were no differences between the exposed and the unexposed mothers for birth outcomes. The estimated differences (exposed vs. unexposed) were 0.01 SDs (95% CI: −0.02, 0.05) for BWZ; 0.10% point (95% CI: −0.95%, 1.16%) for SGA; 0.25% point (95% CI: −0.78%, 1.28%) for LGA; −0.01 week (95% CI: −0.07, 0.05) for GA; and 0.16% point (95% CI: −0.66%, 0.97%) for PTB. Neither trimester-specific nor dose–response associations were observed. Overall, exposure to the 1998 Québec ice storm as a proxy for acute maternal stress in pregnancy was not associated with poor birth outcomes. Our results suggest that acute maternal hardship may not have a substantial effect on adverse birth outcomes.

Keywords

Natural experimentsdifferences-in-differences analysisnatural disastersacute maternal stressbirth outcomes
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 13 , Issue 4 , August 2022 , pp. 471 - 482
Copyright
© The Author(s), 2021. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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