Sustained stress could increase the risk of miscarriage, reveals study.
Several studies have examined the impact of stress on a pregnancy - both chronic stress, such as workload, and acute stress associated with traumatic events like the 9/11 terrorist attacks.
They concluded that stress could lead to adverse birth outcomes, including miscarriage and premature birth.
But few studies assess the impact of continuous military or political stress throughout a pregnancy, said Prof. Liat Lerner-Geva of Tel Aviv University's Sackler Faculty of Medicine and the Women and Children's Health Research Unit at The Gertner Institute for Epidemiology and Health Policy Research Ltd, Tel Hashomer.
Now her new study, conducted with PhD student Tamar Wainstock and Prof. Ilana Shoham-Vardi of Ben Gurion University, Prof. Eyal Anteby of the Barzilai Medical Center, and Saralee Glasser of Gertner Institute, Tel Hashomer, revealed that living under these sustained stresses significantly increases the risk of miscarriage.
Following the pregnancies of women from the Israeli town of Sderot, which is constantly under threat of rocket bombings from Gaza, and women from nearby Kiryat Gat, which is outside of Gaza's rocket range, the researchers demonstrated that those living under rocket fire were 59 percent more likely to miscarry than their neighbors.
These results should be a call-to-action for practitioners, advises Prof. Lerner-Geva, who suggests making intervention readily available to pregnant women in stressful and threatening situations.
Within the exposed group, the researchers also analyzed the intensity of exposure. Not every neighborhood in Sderot was subject to the same number of attacks, notes Prof. Lerner-Geva, and the researchers originally hypothesized that women in higher stress areas would have a higher probability of miscarriage.
However, the results indicate that women in both high-intensity and low-intensity areas were at the same risk. One explanation is that the constant fear of attack is as stressful as the attacks themselves, she concludes.
One advantage that healthcare providers have in dealing with populations under constant threat is that they can make use of early intervention, said Prof. Lerner-Geva.
"Most of the Sderot pregnant women receive prenatal care through community health clinics. This presents an opportunity to run preventive interventions to reduce stress or even provide one-on-one counselling," she added.
Currently, she and her fellow researchers are conducting further studies on the same population to determine whether sustained stress had an impact on other negative birth outcomes, such as preterm delivery or low birth weights.
These results are published in the Psychosomatic Medicine Journal of Biobehavioural Medicine.