Severe stress following bereavement during pregnancy and risk of XXXX : results from a population-based cohort study.

@entity1 @entity393 @entity204 @entity5617
BACKGROUND: Previous findings on the association between stress during pregnancy and @entity393 are inconsistent. We aimed to estimate this association using a large prospective cohort. METHODS: This population-based study included all 1   303   660 clinically recognised pregnancies in Denmark between 1995 and 2008. We categorised @entity1 as exposed to severe stress if they lost a @entity1 , sibling or parent during pregnancy. Cox Proportional Hazards models were used to study the association between exposure and rate of @entity5617 , starting with the follow-up on the day of completion of week 4 of pregnancy. In an attempt to control for unknown potential confounders, we also designed a pregnancy-matched analysis in which each @entity1 had her own baseline risk of @entity393 and controls therefore for genetic and time-stable environmental factors. RESULTS: A total of 146   031 pregnancies ended in clinically recognised fetal loss (11.2%) and a total of 10   808 (0.8%) @entity1 were categorised as exposed. The overall risk of @entity393 was similar in the exposed and unexposed (aHR=1.05, 95% CI 0.95 to 1.15). Results from the pregnancy-matched analysis (performed in 423 @entity1 ) showed stronger and significant associations (aHR=1.83, 95% CI 1.49 to 2.25). All the analyses indicated a stronger effect of bereavement when the mother lost a @entity1 or when the @entity204 was unexpected. CONCLUSIONS: Our main results suggested no strong association between severe stress during pregnancy and risk of @entity393 . Results from the pregnancy-matched analyses considered information from a selected and small group of @entity1 for whom there may exist a stronger association between stress during pregnancy and @entity393 . The fact that an unexpected @entity204 or the loss of a @entity1 had a stronger effect in both analyses may indicate that severe stressful situations increase the risk of @entity393 .
