Introduction

Preterm delivery is one of the most challenging obstetric complication encountered in day to day practice and is the most vulnerable of all complications to manage for paediatricians. It is the single greatest cause of perinatal mortality and morbidity worldwide. Preterm delivery is defined as spontaneous expulsion of the products of conception after viability and before 37 completed weeks. More than 1 million infants die each year because they are born too early according to the just released WHITE PAPER, the Global and Regional Toll of Preterm birth.

1. Federenko IS, Wadhwa PD. Women's mental health during pregnancy influences fetal and infant developmental and health outcomes. CNSSpectr. 2004;9:198–206.
2. Entringer S, Buss C, Wadhwa PD. Prenatal stress, development, health anddisease risk: a psychobiological perspective-2015 Curt Richter Award Paper. Psychoneu-roendocrinology. 2015;62:366–75.
3. Wadhwa PD, Culhane JF, Rauh V, Barve SS. Stress and preterm birth: neuroe-ndocrine, immune/inflammatory, and vascular mechanisms. Matern Child Health J. 2001;5:119–25.
4. Hoirisch-Clapauch S, Brenner B, Nardi AE. Adverse obstetric and neonatal-outcomes in women with mental disorders. Thromb Res. 2015;135.Lilliecreutz et al. BMC Pregnancy and Childbirth (2016) 16:5  Page 7 of 8
5. Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. Women Birth. 2015;28:179– 93.
6. Christian LM. Effects of stress and depression on inflammatory immune-parameters in pregnancy. Am J Obstet Gynecol. 2014;211:275– 7.
7. Glover V. Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms. Adv Neurobiol. 2015;10:269– 83.
8. Brown S, Yelland J, Sutherland G, Baghurst P, Robinson J. Stressful life events, social health issues and low birthweight in an Australian population based birth cohort: challenges and opportunities in antenatal care. BMC Public Health. 2011;11:196.
9. Straub H, Adams M, Kim JJ, Silver RK. Antenatal depressive symptoms increase the likelihood of preterm birth. Am J Obstet Gynecol. 2012;207:329e1 –4.
10. Maternal stress and labor .K. M. Paarlberg, A. J. J. M. Vingerhoets and H. P. van Geijn. DOI: 11.3109/9781439814697-207
11. The Contribution of Maternal Stress to Preterm Birth: Issues and Considerations Pathik D. Wadhwa, MD, PhD,a,c Sonja Entringer, PhD,b,c Claudia Buss, PhD,b,c and Michael C.ClinPerinatol. 2011 Sep; 38(3): 351–384. doi: 1016/j.clp. 2011.06.007

Dr Shaila S

Professor Dept. of O and G, SAT Hospital,

Govt. Medical College, Trivandrum