Niela-Vilen Hannakaisa, Ekholm Eeva, Sarhaddi Fatemeh, Azimi Iman, Rahmani Amir M, Liljeberg Pasi, Pasanen Miko, Axelin Anna
Department of Nursing Science, University of Turku, 20014 University of Turku, Finland.
Department of Obstetrics and Gynaecology, Turku University Hospital, Savitehtaankatu 5, 20520 Turku, Finland.
Sex Reprod Healthc. 2023 Mar;35:100820. doi: 10.1016/j.srhc.2023.100820. Epub 2023 Feb 7.
The aim of this study was to compare subjectively and objectively measured stress during pregnancy and the three months postpartum in women with previous adverse pregnancy outcomes and women with normal obstetric histories.
We recruited two cohorts in southwestern Finland for this longitudinal study: (1) pregnant women (n = 32) with histories of preterm births or late miscarriages January-December 2019 and (2) pregnant women (n = 30) with histories of full-term births October 2019-March 2020. We continuously measured heart rate variability (HRV) using a smartwatch from 12 to 15 weeks of pregnancy until three months postpartum, and subjective stress was assessed with a smartphone application.
We recruited the women in both cohorts at a median of 14.2 weeks of pregnancy. The women with previous adverse pregnancy outcomes delivered earlier and more often through Caesarean section compared with the women with normal obstetric histories. We found differences in subjective stress between the cohorts in pregnancy weeks 29 and 34. The cohort of women with previous adverse pregnancy outcomes had a higher root mean square of successive differences between normal heartbeats (RMSSD), a well-known HRV parameter, compared with the other cohort in pregnancy weeks 26 (64.9 vs 55.0, p = 0.04) and 32 (63.0 vs 52.3, p = 0.04). Subjective stress did not correlate with HRV parameters.
Women with previous adverse pregnancy outcomes do not suffer from stress in subsequent pregnancies more than women with normal obstetric histories. Healthcare professionals need to be aware that interindividual variation in stress during pregnancy is considerable.
本研究旨在比较既往有不良妊娠结局的女性和有正常产科病史的女性在孕期及产后三个月的主观和客观测量的压力。
我们在芬兰西南部招募了两个队列进行这项纵向研究：（1）2019年1月至12月有早产或晚期流产史的孕妇（n = 32），以及（2）2019年10月至2020年3月有足月分娩史的孕妇（n = 30）。我们使用智能手表从怀孕12至15周持续测量心率变异性（HRV）直至产后三个月，并用智能手机应用程序评估主观压力。
我们在两个队列中招募女性时的妊娠中位数为14.2周。与有正常产科病史的女性相比，既往有不良妊娠结局的女性分娩更早且更常通过剖宫产。我们发现两个队列在妊娠第29周和第34周时主观压力存在差异。既往有不良妊娠结局的女性队列在妊娠第26周（64.9对55.0，p = 0.04）和第32周（63.0对52.3，p = 0.04）时，一个著名的HRV参数——正常心跳间连续差值的均方根（RMSSD）高于另一队列。主观压力与HRV参数无相关性。
既往有不良妊娠结局的女性在后续妊娠中承受的压力并不比有正常产科病史的女性更大。医疗保健专业人员需要意识到孕期压力的个体间差异相当大。
