Pattern of perceived stress and anxiety in pregnancy predicts preterm birth
Pattern of perceived stress and anxiety in pregnancy predicts preterm birth
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DOI：
10.1037/0278-6133.27.1.43
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发表时间：
2008-01-01
影响因子：
4.2
通讯作者：
Sandman, Curt A.
中科院分区：
文献类型：
--
作者：
Glynn, Laura M.;Schetter, Christine Dunkel;Sandman, Curt A.
目的：确定产前应激的模式，与在单个妊娠时间点评估的产前应激相比，是否预测早产(PTD)。设计：对415名怀孕18-20周和30-32周的孕妇进行压力和焦虑情绪评估。主要观察指标：妊娠长度由月经末期确定，并经早孕超声确诊。出生被归类为早产(37周)或足月儿。结果：在这两项评估中，焦虑水平或感觉到的压力都不能预测PTD。然而，焦虑和压力的模式与孕期长短有关。尽管大多数足月分娩的女性的压力和焦虑程度有所下降，但早产的女性压力和焦虑程度却有所上升。在对产科风险、妊娠相关焦虑、种族、产次和产前生活事件进行统计调整后，与压力或焦虑增加相关的PTD风险增加持续存在。结论：这些数据表明，产前应激模式是PTD的一个重要预测因子。更广泛地说，这些发现支持这样一种可能性，即怀孕期间压力反应的下降可能有助于保护母亲和胎儿免受与PTD相关的不利影响。
Objective: To determine whether the pattern of prenatal stress, as compared to prenatal stress assessed at a single gestational time point, predicts preterm delivery (PTD). Design: Perceived stress and anxiety were assessed in 415 pregnant women at 18-20 and 30-32 weeks' gestation. Main Outcome Measures: Gestational length was determined by last menstrual period and confirmed by early pregnancy ultrasound. Births were categorized as preterm (< 37 weeks) or term. Results: At neither assessment did levels of anxiety or perceived stress predict PTD. However, patterns of anxiety and stress were associated with gestational length. Although the majority of women who delivered at term exhibited declines in stress and anxiety, those who delivered preterm exhibited increases. The elevated risk for PTD associated with an increase in stress or anxiety persisted when adjusting statistically for obstetric risk, pregnancy-related anxiety, ethnicity, parity, and prenatal life events. Conclusions: These data suggest that the pattern of prenatal stress is an important predictor of PTD. More generally, the findings support the possibility that a decline in stress responses during pregnancy may help to protect mother and fetus from adverse influences associated with PTD.