Maternal Psychotherapy Addressing Generational Stress is Associated with Lower Preterm Birth Risk: The Pforzheim Study

针对代际压力的孕产妇心理治疗与降低早产风险相关:普福尔茨海姆研究

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Abstract

INTRODUCTION: Maternal distress is a significant risk factor for adverse pregnancy and birth outcomes across generations. Psychotherapy can reduce distress and build resilience, potentially mitigating the effects of inter- and transgenerational stress. METHODS: This study examined whether an integrated, personalized psychotherapy approach focused on inter- and transgenerational stress can be associated with improved pregnancy and birth outcomes. Records from 239 women and their babies were collected between 2004 and 2012 at a private clinic specializing in gynecology, obstetrics, psychosomatics, and psychotherapy in Germany. Pregnant women received routine gynecological care alongside complementary psychotherapeutic interventions, including system-oriented psychosomatic therapy, solution-focused therapy, salutogenesis, and couple therapy, with emphasis on inter- and transgenerational stress. These data were compared with birth records from regional standard care deliveries in the city of Pforzheim (n = 18,690) and the state of Baden-Württemberg (n = 815,832). RESULTS: The findings showed that complementary psychotherapy was associated with lower rates of primary and secondary cesarean sections, fewer vaginal surgical procedures, a higher proportion of spontaneous births, and a lower preterm birth rate compared with standard care. Women receiving psychotherapy had an 18.2% higher likelihood of spontaneous birth and a lower observed preterm birth rate (2.2%) than those in standard care (9.0%). Infants of mothers in the psychotherapy group were heavier, taller, and had larger head circumferences. CONCLUSION: In this study, psychotherapeutic counseling within standard gynecological care was linked to longer pregnancy duration, improved birth mode, and greater birth weight. These findings suggest psychotherapy can be a safe, preventive approach during pregnancy to support maternal well-being and promote healthier outcomes for newborns.

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