Gowtham M, Gugapriya T S, Umredkar Ashwini A, Deulkar Snehal
Anatomy, All India Institute of Medical Sciences Nagpur, Nagpur, IND.
Radio-diagnosis, All India Institute of Medical Sciences Nagpur, Nagpur, IND.
Cureus. 2023 Jul 7;15(7):e41517. doi: 10.7759/cureus.41517. eCollection 2023 Jul.
The placenta is an important organ of pregnancy. A multitude of physiological and pathological factors influence blood flow in the placenta during pregnancy. However, the fetal effects of maternal psychological stress were inconclusive. The recent COVID-19 pandemic had unprecedented economic, social, and psychological effects. The effect of COVID-19-induced psychological stress in antenatal women and its resultant fetal impact were studied by observing the Doppler waveforms of the uterine and umbilical arteries.
The cross-sectional study was conducted on 26 healthy third-trimester antenatal women who satisfied pre-set inclusion and exclusion criteria. A pandemic-related pregnancy stress scale (PREPS) was used to evaluate the stress in pregnant women and categorize it into mild, moderate, and severe levels. The Doppler ultrasound of the uterine and umbilical vessels was done along with a routine growth scan in the third trimester of pregnancy. The arterial waveforms, Pulsatility index (PI) of uterine and umbilical arteries, umbilical vein blood flow, and biometric parameters of the fetus were recorded and analyzed.
Seventeen of the 26 participants were found to be moderately stressed. Among the three dimensions of the PREPS tool, the perinatal infection stress dimension was expressed predominantly. A strong expression of the positive affirmation dimension was seen in antenatal women. The mean Pulsatility index in the mild, moderate, and severe groups was 0.74, 0.93, and 0.63, respectively. The association between the PREPS score and the Pulsatility index of the umbilical artery alone was found to be significant at p=0.02.
The COVID-19 pandemic caused moderate to severe levels of psychological stress in pregnant women. The statistically significant association between the PREPS score and the umbilical artery PI indicates possible fetoplacental compromise, suggesting the need for cognitive therapy to manage psychological stress in antenatal women.
胎盘是妊娠期间的一个重要器官。众多生理和病理因素会影响孕期胎盘的血流。然而，母亲心理压力对胎儿的影响尚无定论。近期的新冠疫情产生了前所未有的经济、社会和心理影响。通过观察子宫和脐动脉的多普勒波形，研究了新冠疫情引发的心理压力对产前女性的影响及其对胎儿的影响。
对26名符合预设纳入和排除标准的健康孕晚期产前女性进行了横断面研究。使用与疫情相关的妊娠压力量表（PREPS）评估孕妇的压力，并将其分为轻度、中度和重度。在妊娠晚期进行子宫和脐血管的多普勒超声检查以及常规生长扫描。记录并分析动脉波形、子宫和脐动脉的搏动指数（PI）、脐静脉血流以及胎儿的生物测量参数。
26名参与者中有17名被发现处于中度压力状态。在PREPS工具的三个维度中，围产期感染压力维度表现最为突出。产前女性中积极肯定维度表现强烈。轻度、中度和重度组的平均搏动指数分别为0.74、0.93和0.63。仅发现PREPS评分与脐动脉搏动指数之间的关联具有统计学意义，p = 0.02。
新冠疫情给孕妇造成了中度至重度的心理压力。PREPS评分与脐动脉PI之间具有统计学意义的关联表明可能存在胎儿胎盘功能不全，这表明需要采用认知疗法来管理产前女性的心理压力。
