The complex impact of five years of stress related to life-threatening events on pregnancy outcomes: A preliminary retrospective study

Objective: To study the impact of chronic, life-threatening stressors in the form of daily missile attacks, for five consecutive years, on pregnancy outcomes. Method: Charts of deliveries from two neighboring towns in the south of Israel, covering the years 2000 and 2003-2008, were reviewed retrospectively. One city had been exposed to missile attacks, while the other was not. For each year, 100 charts were chosen at random. Results: Significant association was found between exposure to stress and frequency of pregnancy complications ( P= 0.047) and premature membrane rupture ( P= 0.029). A more detailed analysis, based on dividing the stressful years into three distinct periods: early (2003-2004), intermediate (2005-2006) and late (2007-2008), revealed that preterm deliveries were significantly more frequent ( P= 0.044) during the intermediate period, as was premature membrane rupture during the late period ( P= 0.014). Conclusion: Exposure to chronic life-threatening stress resulted in more pregnancy complications and in particular more premature membrane ruptures. The impact was most significant during the middle period of the 5-year-exposure to the stressor. Hence it seems that factors of duration and habituation may play a role in the impact of chronic, life-threatening stressors on pregnancy.