{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T01:35:55Z","timestamp":1770514555604,"version":"3.49.0"},"reference-count":30,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2015,10,29]]},"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Previous findings on the association between stress during pregnancy and pregnancy loss are inconsistent. We aimed to estimate this association using a large prospective cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This population-based study included all 1\u2005303\u2005660 clinically recognised pregnancies in Denmark between 1995 and 2008. We categorised women as exposed to severe stress if they lost a child, sibling or parent during pregnancy. Cox Proportional Hazards models were used to study the association between exposure and rate of fetal death, starting with the follow-up on the day of completion of week 4 of pregnancy. In an attempt to control for unknown potential confounders, we also designed a pregnancy-matched analysis in which each woman had her own baseline risk of pregnancy loss and controls therefore for genetic and time-stable environmental factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 146\u2005031 pregnancies ended in clinically recognised fetal loss (11.2%) and a total of 10\u2005808 (0.8%) women were categorised as exposed. The overall risk of pregnancy loss was similar in the exposed and unexposed (aHR=1.05, 95% CI 0.95 to 1.15). Results from the pregnancy-matched analysis (performed in 423 women) showed stronger and significant associations (aHR=1.83, 95% CI 1.49 to 2.25). All the analyses indicated a stronger effect of bereavement when the mother lost a child or when the death was unexpected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our main results suggested no strong association between severe stress during pregnancy and risk of pregnancy loss. Results from the pregnancy-matched analyses considered information from a selected and small group of women for whom there may exist a stronger association between stress during pregnancy and pregnancy loss. The fact that an unexpected death or the loss of a child had a stronger effect in both analyses may indicate that severe stressful situations increase the risk of pregnancy loss.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2015-206241","type":"journal-article","created":{"date-parts":[[2016,1,7]],"date-time":"2016-01-07T13:29:17Z","timestamp":1452173357000},"page":"424-429","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Severe stress following bereavement during pregnancy and risk of pregnancy loss: results from a population-based cohort study"],"prefix":"10.1136","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6470-7465","authenticated-orcid":false,"given":"Oleguer","family":"Plana-Ripoll","sequence":"first","affiliation":[{"name":"Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Parner","sequence":"additional","affiliation":[{"name":"Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f8rn","family":"Olsen","sequence":"additional","affiliation":[{"name":"Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark"},{"name":"Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiong","family":"Li","sequence":"additional","affiliation":[{"name":"Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,11,19]]},"reference":[{"key":"2025100301340722000_70.5.424.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198807283190401"},{"key":"2025100301340722000_70.5.424.2","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23014"},{"key":"2025100301340722000_70.5.424.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62310-0"},{"key":"2025100301340722000_70.5.424.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7251.1708"},{"key":"2025100301340722000_70.5.424.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62233-7"},{"key":"2025100301340722000_70.5.424.6","unstructured":"Kline J , Stein Z , Susser M . 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