Harpreet S Chahal1,2, Bizu Gelaye1,3, Elizabeth Mostofsky1,4, Manuel S Salazar5, Sixto E Sanchez6,7, Cande V Ananth8,9, Michelle A Williams1. 1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 2. Mississauga Academy of Medicine, University of Toronto Mississauga, Mississauga, ON, Canada. 3. Department of Psychiatry, Harvard Medical School, Boston, MA, USA. 4. Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA. 5. Departamento de Gineco Obstetricia, Universidad Nacional Mayor de San Marcos, Lima, Peru. 6. Facultad de Medicina, Universidad de San Martin de Porres, Lima, Peru. 7. Asociación Civil Proyectos en Salud, Lima, Peru. 8. Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA. 9. Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA.
Abstract
BACKGROUND: Roughly, a fourth of all placental abruption cases have an acute aetiologic underpinning, but the causes of acute abruption are poorly understood. Studies indicate that symptoms of stress, depression, and anxiety during pregnancy may be associated with a higher risk of abruption. OBJECTIVE: We examined the rate of abruption in the 2 hours immediately following outbursts of anger. METHODS: In a multicentre case-crossover study, we interviewed 663 women diagnosed with placental abruption admitted to one of the seven Peruvian hospitals between January 2013 and August 2015. We asked women about outbursts of anger before symptom onset and compared this with their usual frequency of anger during the week before abruption. RESULTS: The rate of abruption was 2.83-fold (95% confidence interval [CI] 1.85, 4.33) higher in the 2 hours following an outburst of anger compared with other times. The rate ratio (RR) was lower for women who completed technical school or university (RR 1.38, 95% CI 0.52, 3.69) compared to women with secondary school education or less (RR 3.73, 95% CI 2.32, 5.99, P-homogeneity = .07). There was no evidence that the association between anger episodes and abruption varied by hypertensive disorders of pregnancy (ie preeclampsia/ eclampsia) or antepartum depressive symptoms. CONCLUSION: There was a higher rate of abruption in the 2 hours following outbursts of anger compared with other times, providing potential clues to the aetiologic mechanisms of abruption of acute onset.
BACKGROUND: Roughly, a fourth of all placental abruption cases have an acute aetiologic underpinning, but the causes of acute abruption are poorly understood. Studies indicate that symptoms of stress, depression, and anxiety during pregnancy may be associated with a higher risk of abruption. OBJECTIVE: We examined the rate of abruption in the 2 hours immediately following outbursts of anger. METHODS: In a multicentre case-crossover study, we interviewed 663 women diagnosed with placental abruption admitted to one of the seven Peruvian hospitals between January 2013 and August 2015. We asked women about outbursts of anger before symptom onset and compared this with their usual frequency of anger during the week before abruption. RESULTS: The rate of abruption was 2.83-fold (95% confidence interval [CI] 1.85, 4.33) higher in the 2 hours following an outburst of anger compared with other times. The rate ratio (RR) was lower for women who completed technical school or university (RR 1.38, 95% CI 0.52, 3.69) compared to women with secondary school education or less (RR 3.73, 95% CI 2.32, 5.99, P-homogeneity = .07). There was no evidence that the association between anger episodes and abruption varied by hypertensive disorders of pregnancy (ie preeclampsia/ eclampsia) or antepartum depressive symptoms. CONCLUSION: There was a higher rate of abruption in the 2 hours following outbursts of anger compared with other times, providing potential clues to the aetiologic mechanisms of abruption of acute onset.
Authors: John S Gottdiener; Willem J Kop; Eva Hausner; Melissa K McCeney; David Herrington; David S Krantz Journal: Am J Cardiol Date: 2003-09-15 Impact factor: 2.778
Authors: Sonia M Grandi; Kristian B Filion; Sarah Yoon; Henok T Ayele; Carla M Doyle; Jennifer A Hutcheon; Graeme N Smith; Genevieve C Gore; Joel G Ray; Kara Nerenberg; Robert W Platt Journal: Circulation Date: 2019-02-19 Impact factor: 29.690
Authors: Andrew Smyth; Martin O'Donnell; Pablo Lamelas; Koon Teo; Sumathy Rangarajan; Salim Yusuf Journal: Circulation Date: 2016-10-11 Impact factor: 29.690
Authors: Cande V Ananth; Morgan R Peltier; Martin R Chavez; Russell S Kirby; Darios Getahun; Anthony M Vintzileos Journal: Obstet Gynecol Date: 2007-07 Impact factor: 7.661
Authors: Monika Bączkowska; Katarzyna Kosińska-Kaczyńska; Magdalena Zgliczyńska; Robert Brawura-Biskupski-Samaha; Beata Rebizant; Michał Ciebiera Journal: Int J Environ Res Public Health Date: 2022-04-23 Impact factor: 4.614