STRESS AND RISK FOR ADVERSE REPRODUCTIVE OUTCOME

点击翻译按钮获取中文摘要

The objective of the proposed research is to examine the relationship between work-related psychological stress and risk for spontaneous abortion and menstrual dysfunction. Preliminary data indicate that work-related psychological stress may adversely effect female reproductive performance. This research is intended to estimate the magnitude of the adverse effects of stress on spontaneous abortion and to examine the role that hormonal function might play in mediating any effects of stress on reproduction. There are two components. (1) The relationship of work-related stress to spontaneous abortion will be examined by analyzing data collected from a prospective study of 5300 pregnant women by comparing stress and other risk factors in women with and without spontaneous abortion. A detailed questionnaire collected information on industry and type of work performed, stress-related factors at work, life events, "wantedness" of pregnancy, social support at work and at home, physical exertion at work and at home, exercise, reproductive history, consumption of tobacco, alcohol and caffeinated beverages, chronic illnesses requiring medication and use of contraception around the time of conception. Analyses will include Cox life table regression. (2) The effect of work-related psychological stress on hormonal function and ovulation will be studied by analyzing data collected in a prospective study of 410 women at risk of becoming pregnant. Daily urine samples were collected for up to six months and analyzed for hormone metabolites, providing information on occurrence of ovulation and length of follicular and luteal phases. A questionnaire assessed sociodemographic information, reproductive history, health status and medication use, caffeine and alcohol consumption, cigarette and passive smoking, occupation and information on specific work-place exposures (such as solvents psychological stress at work, life events, social support at work and at home, nonspecific psychological distress, physical exertion at work and home, exercise, and demographic information on spouse. -Whether work-related stress is associated with alteration in menstrual cycles, increases in anovulatory cycles, or alterations in urinary steroid conjugate levels will be examined. Since the data involve replicate measures of binary effect with differing numbers of replicates per subject, analyses will include innovative modeling techniques. Data collection for these components has been completed. Funds provided by this award would be used for data analysis only. The information gained will be useful for programs to prevent the adverse effects of stress on female reproduction.