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    Physical or Mental Stress May Be Associated With Birth Defects or Miscarriage

    By Elizabeth Tracey , MS
    WebMD Health News

    Jan. 12, 2000 (Baltimore) -- Everyone wants to avoid stress. Now two studies in the January issue of the journal Epidemiology give women who have just become pregnant even more reason to steer clear of tension. The studies showed that women who experience mental or physical stress around the time they become pregnant or for the first few months of pregnancy may be at increased risk of either miscarriage, also called spontaneous abortion, or of having an infant with a birth defect .

    "Our study shows a modest association between stressful events and congenital anomalies [birth defects]," says Suzan Carmichael, PhD, lead author of one of the papers, in an interview with WebMD. "It's still somewhat preliminary given the limited number of questions we asked about stress, but it does point the way for future studies," says Carmichael, an epidemiologist with the March of Dimes/California Birth Defects Monitoring Program in Emeryville, Calif.

    Carmichael and colleagues collected data from mothers who had had an infant with one of several types of birth defects and whose pregnancies ended during 1987-89 in California. They compared this data with that from mothers who delivered healthy infants during the same time period.

    Mothers were interviewed by telephone and asked about stressful exposures during the periconceptual period, defined as one month before conception until the end of the third month of pregnancy. "Questions about stressful events included deaths of anyone close to the mother, separation or divorce in the mother or someone close to her, or job loss in the mother or someone close to her during the periconceptual period," says Carmichael. "Stressful events during this period were associated with a moderate increase in congenital anomalies."

    Dr. Paul Blumenthal, MD, associate professor of obstetrics and gynecology at Johns Hopkins University in Baltimore, who gave objective comment on the papers to WebMD, says, "This study was retrospective and therefore subject to recall bias. Women who have had bad outcomes have been shown to be much more likely to recall negative events during pregnancy than those with good outcomes. There are also some serious statistical problems with this paper."

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