Ramiro-Cortijo David, de la Calle Maria, Benitez Vanesa, Gila-Diaz Andrea, Moreno-Jiménez Bernardo, Arribas Silvia M, Garrosa Eva
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain.
J Pers Med. 2021 Mar 5;11(3):183. doi: 10.3390/jpm11030183.
Early detection of gestational complications is a priority in obstetrics. In our social context, this is linked to maternity age. Most studies are focused on biological factors. However, pregnancy is also influenced by social and psychological factors, which have not been deeply explored. We aimed to identify biopsychosocial risk and protective factors associated with the development of maternal and fetal complications. We enrolled 182 healthy pregnant women, and plasma melatonin and cortisol levels were measured in the first trimester by chemiluminescent immunoassays. At different time points along gestation, women answered several questionnaires (positive and negative affect schedule, hospital anxiety and depression scale, pregnancy concerns scale, life orientation test, resilience scale, life satisfaction scale and life-work conflicts scale). They were followed up until delivery and categorized as normal pregnancy, maternal or fetal complications. Maternal complications were associated with low melatonin (OR = 0.99 [0.98; 1.00]; -value = 0.08) and life satisfaction (OR = 0.64 [0.41; 0.93]; -value = 0.03) and fetal complications were associated with high cortisol (OR = 1.06 [1.02; 1.13]; -value = 0.04), anxiety (OR = 2.21 [1.10; 4.55]; -value = 0.03) and life-work conflicts (OR = 1.92 [1.04; 3.75]; -value = 0.05). We conclude that psychological factors influence pregnancy outcomes in association with melatonin and cortisol alterations. High maternal melatonin and life satisfaction levels could be potential protective factors against the development of maternal complications during pregnancy. Low anxiety and cortisol levels and reduced work-life conflicts could prevent fetal complications.
早期发现妊娠并发症是产科的首要任务。在我们的社会背景下，这与产妇年龄有关。大多数研究都集中在生物学因素上。然而，妊娠也受到社会和心理因素的影响，而这些因素尚未得到深入探讨。我们旨在确定与母婴并发症发生相关的生物心理社会风险和保护因素。我们招募了182名健康孕妇，在孕早期通过化学发光免疫分析法测量血浆褪黑素和皮质醇水平。在孕期的不同时间点，孕妇回答了几份问卷（积极和消极情绪量表、医院焦虑和抑郁量表、妊娠担忧量表、生活取向测试、复原力量表、生活满意度量表和生活-工作冲突量表）。她们被随访至分娩，并分为正常妊娠、母体或胎儿并发症。母体并发症与低褪黑素水平（OR = 0.99 [0.98; 1.00]; P值 = 0.08）和生活满意度（OR = 0.64 [0.41; 0.93]; P值 = 0.03）相关，胎儿并发症与高皮质醇水平（OR = 1.06 [1.02; 1.13]; P值 = 0.04）、焦虑（OR = 2.21 [1.10; 4.
