When Pregnant Women Live in Risky Places

Miscarriage rate higher among pregnant women subjected to more living stress

(RxWiki News) Most people have the good fortune not to live in a town under regular rocket attacks. However, lessons can be learned from the experiences of pregnant women in such places.

A recent study found that pregnant women living in a town under regular attack had a higher percentage of miscarriages than women in another nearby town.

These researchers suspect that the ongoing stress of living in a place under attack with stressful warning alarms might have played a part in the higher rate.

These findings might point to higher miscarriage rates among any pregnant women in extremely stressful circumstances.

"Experiencing stress? Talk to your OB/GYN."

The study, led by Tamar Wainstock, MMedSc, of the Department of Epidemiology at Ben Gurion University of the Negev in Israel, aimed to understand whether miscarriages might be more likely among women exposed to life-threatening situations.

In this study, the researchers specifically focused on women living in an area that regularly receives rocket attacks. The 3,488 women studied lived in either the Israeli town of Sderot or the town of Kiryat Gat.

Sderot has been targeted with rockets from the Gaza Strip since 2001 and, before each rocket attack, the city plays warning sirens so that residents can take shelter. Over 1,000 warning alarms were played between 2001 and 2008, and at least 13 residents have been killed by the rocket attacks since 2001.

Kiryat Gat is not far from Sderot, but this town is out of the range of rockets from the Gaza Strip. Therefore, the miscarriage rates of 1,345 pregnant women subjected to the warning sirens and rocket attacks in Sderot were compared to those of 2,143 pregnant women in Kiryat Gat.

The miscarriage rate in Kiryat Gat was 4.7 percent, which matches the historical rates that would be expected in this area. The rate among women in Sderot was 6.9 percent.

After calculating in the possible effects of differences among the women, such as age and other medical conditions, the researchers determined that women exposed to the rocket attacks and warnings were 59 percent more likely to experience a miscarriage than the women not subjected to that regular stress.

"The findings demonstrate a significantly increased risk of [miscarriage] among women exposed to potentially life-threatening situations for a prolonged period, both before and during pregnancy, compared with women of similar demographic characteristics who were not exposed to missile attack alarms or missile attacks," the authors wrote.

While women living in a stressful place or in stressful conditions of any kind might not be able to move or remove the stressors, they can seek help for the stress, according to co-author Liat Lerner-Geva, PhD, MD.

"Most of the Sderot pregnant women receive prenatal care through community health clinics," Dr. Lerner-Geva said in a prepared statement.

"This presents an opportunity to run preventive interventions to reduce stress or even provide one-on-one counseling."

One limitation of this study was that the authors did not measure stress on the women directly. They were only able to show that the rate of miscarriages overall in a village under regular attack was significantly higher than the rate in a similar village not under regular assault.

The study was published in the April issue of the journal Psychosomatic Medicine Journal of Biobehavioural Medicine. The research was funded by the Ministry of Health in Israel. The authors reported no conflicts of interest.

Review Date: 
April 8, 2013