EPIDEMIOLOGIC STUDY OF STRESS IN PREGNANCY

这项建议旨在完成一项关于生活压力的前瞻性研究 怀孕，一个长期以来一直是产科关注的问题 从业者。样本包括500名产前患者的队列 在两个紧密相似的区域中的每一个聚集在一起，他们被跟踪到六个 产后几周。自变量分为两大类。 课程：急性个人生活压力源和慢性社区压力源， 两者都在怀孕期间的几个时间点进行了测量。因变量为 在此基础上选择的母亲和子女的具体不良后果 生物学上的可信性。这项研究的一个独特之处是使用了 要测量的生物标志物(主要是尿儿茶酚胺水平) 应激的生理反应和可能的干预途径 生殖结果的压力源。社会支持、应对方式与心理健康的关系 控制被评估为潜在的调节变量。一系列 已知的影响妊娠结局的经历--包括 可能会受到压力(如吸烟、饮酒)的影响-被测量为 潜在的混杂变量或影响效果的变量。效果的测试 严重的个人压力与所报告的生活事件有关。测试的结果 慢性社区压力的影响部分取决于主题报告 感觉到的威胁，部分是关于两个社会人口学上的比较 类似区域：一个靠近核电站(三里岛)； 其他人不是；而且两者都同样面临来自其他人的感知威胁 环境危害，如氡。 这项研究开展得很好，所有程序都已充分运作。 连续性有赖于及时的补充资金。

This proposal aims to complete a prospective study of life stress in pregnancy, an issue that has long been a concern of obstetric practitioners. The sample comprises cohorts of 500 prenatal patients assembled in each of two closely comparable areas, who are followed to six weeks postpartum. The independent variables fall into two broad exposure classes: acute individual life stressors and chronic community stressors, both measured at several points in pregnancy. The dependent variables are specific adverse outcomes for mother and offspring selected on the basis of biologic plausibility. A unique feature of the study is the use of biological markers (principally urinary catecholamine levels) to measure both physiologic response to stress and possible intervening pathways from stressors to reproductive outcome. Social support, coping and locus of control are assessed as potential moderating variables. A range of experiences known to affect pregnancy outcome - including behaviors that may be influenced by stress (e.g., smoking, drinking) - are measured as potential confounding or effect-modifying variables. Tests of the effects of acute individual stress relate to reported life events. Tests of the effects of chronic community stress depend partly on subject reports of perceived threat and partly on the comparison of two sociodemographically similar areas: one proximate to a nuclear plant (Three Mile Island); the other not; and both equally exposed to perceived threats from other environmental hazards such as radon. The study is well-launched, with all procedures fully operational. Continuity depends on timely supplemental funding.