University of Utah College of Nursing, Salt Lake City, UT, USA.
Biol Res Nurs. 2010 Oct;12(2):125-36. doi: 10.1177/1099800410377111. Epub 2010 Aug 26.
This exploratory study examines the role of psychosocial-behavioral variables as predictors of elevated corticotropin-releasing hormone (CRH) at 14-20 weeks of gestation.
One hundred and twenty women were enrolled into the study. Blood samples were collected at 14-20 weeks of pregnancy and assayed for CRH. Participants completed questionnaires that included the Perceived Stress Scale, the Center for Epidemiologic Studies (CES) Depression Scale, the Pregnancy-Specific Anxiety (PAS) Scale, the Norbeck Social Support Questionnaire, the Life Orientation Test, the Brief COPE scale, and questions regarding violence/abuse, and work, sleep, and nutritional patterns.
Pregnant women with high CRH levels (15 pcg/ml and above) perceived their income to be inadequate, slept more hours at night, stood more hours during the day, and used the coping styles of disengagement or religion but not humor. Logistic regression identified three predictors for high CRH (accounting for 42.2% of the variance): perceived inadequacy of income and the use of ''religion'' and ''disengagement'' to cope with stress.
These results are the first known to identify coping style and perceived income inadequacy as predictors of high CRH. Women with perceived inadequacy of income had almost three times the odds for high CRH. Women who used religion or disengagement to cope with stress had 14 times and 7 times the odds for high CRH levels, respectively. Higher CRH levels are associated with preterm birth (PTB). Thus, it may be important to include maternal coping style and perceptions of income inadequacy in future investigations of CRH levels and PTB.
本探索性研究旨在考察心理社会行为变量在预测妊娠 14-20 周时促肾上腺皮质激素释放激素（CRH）升高中的作用。
本研究纳入了 120 名女性。在妊娠 14-20 周时采集血样并检测 CRH。参与者完成了包括压力知觉量表、流行病学研究中心抑郁量表、妊娠特异性焦虑量表、诺贝克社会支持问卷、生活取向测验、简要应对量表以及有关暴力/虐待、工作、睡眠和营养模式的问题的问卷。
CRH 水平较高（15pcg/ml 及以上）的孕妇认为自己的收入不足，夜间睡眠时间更长，白天站立时间更长，采用回避或宗教应对方式，但不采用幽默应对方式。Logistic 回归确定了三个预测 CRH 升高的因素（解释了 42.2%的方差）：收入不足的感知以及宗教和回避作为压力应对方式的使用。
这些结果首次表明，应对方式和收入不足的感知是 CRH 升高的预测因素。收入不足的孕妇发生 CRH 升高的可能性几乎是其他人的三倍。使用宗教或回避来应对压力的女性发生 CRH 升高的可能性分别是其他人的 14 倍和 7 倍。较高的 CRH 水平与早产（PTB）相关。因此，在未来对 CRH 水平和 PTB 的研究中，纳入产妇应对方式和收入不足的感知可能很重要。
