Mental health & preterm birth: abstract submission for oral presentation

Article type
Authors
Tsoa E1, Bourdages N1, Mather J1
1Toronto Public Health
Abstract
Background: According to the World Health Organization, preterm birth (PTB) is the leading cause of infant mortality and morbidity. Infants born preterm are at greater risk of health and developmental problems, with significant implications for public health. Over the past 10 years, Toronto's PTB birth rate of 9% has been relatively stable, and is higher than the provincial average of 8%.
Recent evidence has shown that mental health concerns are a contributing factor to PTB. In Toronto, the rate of women experiencing any mental health concern during pregnancy increased from 8% in 2013 to 10% in 2016. Recent evidence has shown that mental health concerns are a contributing factor to PTB. In Toronto, the rate of women experiencing any mental health concern during pregnancy increased from 8% in 2013 to 10% in 2016. Given these findings, Toronto Public Health (TPH), Canada's largest local public health agency which provides public health programs and services to 2.8 million residents, prioritized a rapid review to determine whether mental health promotion strategies had an influence on PTB.

Objectives: To complete a rapid review of the recent evidence based on the following PICO (Population, Intervention, Comparison, Outcome) question: How do mental health promotion strategies relevant to public health practice influence preterm birth?
Methods: A rapid review was conducted. Various electronic databases were searched for systematic reviews and meta-analyses. A total of 726 records were screened based on the inclusion and exclusion criteria. A total of 11 articles were ultimately selected for inclusion in the rapid review. Each article was independently appraised for quality by the three reviewers.

Results: The overall results from this review found:
• a lack of evidence of public health interventions addressing mental health concerns during
pregnancy that aim to reduce preterm labour and birth;
• that mental health concerns during pregnancy, such as depression, anxiety, and perceived stress can increase the risk for, or is significantly associated with PTB;
• a positive association between exposure to intimate partner violence and PTB.

Conclusions: This rapid review did not find evidence about effective mental health promotion strategies relevant to public health that address PTB. However, the evidence did show an association between depression, anxiety and perceived stress on PTB.

Patient or healthcare consumer involvement: One recommendation from this rapid review is to raise awareness with the general public about the association between PTB and mental health concerns. Toronto Public Health is exploring collaborations with other stakeholders to further pursue this work.