Agarwal Isha, Puissant Madeleine, Altman Irit, Hinton Alexandra, Strout Tania D, Sabbath Erika L
Department of Emergency Medicine, Maine Medical Center, Portland, ME, USA.
Center for Interdisciplinary and Population Health Research, MaineHealth Institute for Research, Portland, ME, USA.
Pilot Feasibility Stud. 2025 Apr 26;11(1):55. doi: 10.1186/s40814-025-01647-z.
Most studies of stress during pregnancy have relied on self-reported and recalled measures, leaving a knowledge gap about the impact of acute, or momentary, stressors. Heart rate, blood pressure, and cortisol are physiologic measures known to increase acutely in response to acute stress. The feasibility of collecting these measures has not been widely reported among pregnant workers outside of a controlled laboratory setting.
This pilot study assessed the feasibility and tolerability of measuring ambulatory heart rate, blood pressure, and diurnal urine cortisol during periods of work and rest among pregnant nurses, nursing assistants, and clinical technicians.
Over a 9-month enrollment period, we received 31 inquiries from potential candidates, of whom 18 met our eligibility criteria and 12 accepted enrollment (67% acceptance rate). Over the study period, 4 enrollees withdrew their participation, and 8 were retained until the end of the study (67% completion rate). Our feasibility threshold was the acquisition of ≥ 80% of expected measurements for heart rate, blood pressure, and urine cortisol among retained participants. We achieved our feasibility target for blood pressure recordings (acquiring 84% of expected measures) but not for heart rate recordings (acquiring 60% of expected measures). Urine cortisol levels were successfully obtained 97% of the time. Through qualitative analysis of comments provided by study participants, we identified three major themes surrounding barriers to completing physiological monitoring: (1) personal discomfort and technical issues with study equipment, (2) work or activity interference, and (3) concerns about study design.
While physiologic monitoring of pregnant workers is important for learning about how work might impact pregnancy outcomes, equipment challenges pose a significant barrier to study participation. Future studies should allow for a significant withdrawal rate or explore alternative equipment options.
大多数关于孕期压力的研究都依赖自我报告和回忆性测量方法，这使得我们对急性或瞬间压力源的影响存在知识空白。心率、血压和皮质醇是已知会因急性压力而急性升高的生理指标。在受控实验室环境之外，在怀孕的工作人员中收集这些指标的可行性尚未得到广泛报道。
这项试点研究评估了在怀孕护士、护理助理和临床技术人员的工作和休息期间测量动态心率、血压和日间尿皮质醇的可行性和耐受性。
在为期9个月的招募期内，我们收到了31名潜在候选人的咨询，其中18人符合我们的资格标准，12人接受了招募（接受率67%）。在研究期间，4名参与者退出，8名参与者被保留到研究结束（完成率67%）。我们的可行性阈值是在保留的参与者中获取≥80%的心率、血压和尿皮质醇预期测量值。我们实现了血压记录的可行性目标（获取了84%的预期测量值），但未实现心率记录的目标（获取了60%的预期测量值）。尿皮质醇水平在97%的时间内成功获得。通过对研究参与者提供的评论进行定性分析，我们确定了围绕完成生理监测障碍的三个主要主题：（1）对研究设备的个人不适和技术问题，（2）工作或活动干扰，以及（3）对研究设计的担忧。
虽然对怀孕工作人员进行生理监测对于了解工作如何影响妊娠结局很重要，但设备挑战对参与研究构成了重大障碍。未来的研究应考虑到较高的退出率或探索替代设备选项。
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