Duke-NUS Medical School, Singapore.
KK Women's and Children's Hospital, Singapore.
Asian J Psychiatr. 2020 Feb;48:101923. doi: 10.1016/j.ajp.2019.101923. Epub 2019 Dec 28.
To determine common temporal change patterns (i.e., trajectories) of perceived antenatal psychological stress throughout the pregnancy, and to examine associations between these identified trajectories and neonatal birth outcomes.
926 participants from a prospective cohort study of multi-ethnic Asian women from an urban setting with uncomplicated singleton pregnancies completed the Perceived Stress Scale in their first, second, and third trimesters, and just prior to parturition. Gestational age, neonatal weight, length, and head circumference were recorded at birth. Longitudinal trajectories of antenatal psychological stress were characterized with group-based trajectory modelling; associations between trajectories and neonatal outcomes were assessed with analyses of covariance and covariate-adjusted linear regressions.
Three distinct non-fluctuating trajectories of antenatal psychological stress were identified, with 43 % of women experiencing significant levels of stress throughout the pregnancy. Women in this persistently-higher stress trajectory delivered neonates who were 57.5 g lighter and with head circumferences of 20 mm less than their counterparts in the other trajectories. Each one-point increase on the Perceived Stress Scale was associated with a decrease of 5.64 g in birthweight and a decrease of 0.4 mm in head circumference.
This study delineated three meaningful trajectories of antenatal psychological stress. The persistently-higher antenatal psychological stress trajectory, experienced by two in five women, was associated with lower birthweight and possibly smaller head circumference. While further research is needed to better appreciate the clinical relevance of these findings, it highlights the importance of psychosocial support even for healthy pregnant women with uncomplicated pregnancies in Asian settings.
确定整个孕期中感知产前心理压力的常见时间变化模式（即轨迹），并探讨这些确定的轨迹与新生儿出生结局之间的关系。
926 名来自亚洲多民族城市环境中复杂单胎妊娠前瞻性队列研究的参与者，在妊娠的第一、第二和第三孕期以及分娩前完成了感知压力量表的测试。在出生时记录了胎龄、新生儿体重、长度和头围。采用基于群组的轨迹建模来描述产前心理压力的纵向轨迹；通过协方差分析和协变量调整线性回归来评估轨迹与新生儿结局之间的关系。
确定了三种不同的非波动产前心理压力轨迹，其中 43%的女性在整个孕期经历了显著水平的压力。在这个持续高压力轨迹中的女性，新生儿体重轻 57.5 克，头围小 20 毫米，与其他轨迹中的新生儿相比。感知压力量表上的每增加一个点，出生体重就会减少 5.64 克，头围就会减少 0.4 毫米。
本研究描绘了三种有意义的产前心理压力轨迹。五分之二的女性经历了持续较高的产前心理压力轨迹，与较低的出生体重和可能较小的头围有关。虽然需要进一步的研究来更好地了解这些发现的临床意义，但它强调了即使在亚洲环境中对健康、无并发症的孕妇提供社会心理支持的重要性。
