Lederman R P, Lederman E, Work B A, McCann D S
Birth Defects Orig Artic Ser. 1981;17(6):5-28.
A study of 32 normal married primigravidas was conducted to determine the relationships among maternal psychological and physiological variables, subsequent progress in labor, and the health status of the fetus and neonate. At the onset of phase 2 of labor (3 cm of cervical dilatation), self-reported anxiety and endogenous plasma epinephrine were significantly correlated. With the deletion of subjects to control for the effect of medications, higher epinephrine levels were significantly associated with lower uterine contractile activity at the onset of phase 2 and with longer labor in phase 2 (3-10 cm of cervical dilatation). Psychological variables measured in pregnancy correlated significantly with the variables measured at the onset of phase 2 labor. Conflict concerning the acceptance of pregnancy showed the most significant relationships to the phase 2 labor variables, with correlations of 0.39 for anxiety, 0.59 for plasma epinephrine, -0.70 and -0.52 for the two adjacent Montevideo units, and 0.58 for duration of labor in phase 2. Conflict regarding the acceptance of pregnancy also correlated significantly with the newborns' 5 minute Apgar scores. Anxiety in labor and plasma epinephrine were significantly correlated with the fetal heart rate pattern during phase 2 of active labor. The fetal heart rate pattern was significantly correlated with newborns' Apgar scores at 1 and 5 minutes. The results of this study support the following hypotheses: conflicts in pregnancy are predictive of maternal anxiety and stress-related biochemical factors, and these variables are related to prolonged labor and to fetal-newborn depression.
对32名正常初产妇进行了一项研究，以确定母亲心理和生理变量、分娩后续进展以及胎儿和新生儿健康状况之间的关系。在分娩第二期开始时（宫颈扩张3厘米），自我报告的焦虑与内源性血浆肾上腺素显著相关。在剔除使用药物影响的受试者后，较高的肾上腺素水平与第二期开始时较低的子宫收缩活动以及第二期（宫颈扩张3 - 10厘米）较长的产程显著相关。孕期测量的心理变量与分娩第二期开始时测量的变量显著相关。关于接受怀孕的冲突与第二期分娩变量的关系最为显著，焦虑的相关性为0.39，血浆肾上腺素为0.59，两个相邻的蒙得维的亚单位分别为-0.70和-0.52，第二期产程持续时间为0.58。关于接受怀孕的冲突也与新生儿5分钟阿氏评分显著相关。分娩时的焦虑和血浆肾上腺素与活跃期分娩第二期的胎儿心率模式显著相关。胎儿心率模式与新生儿1分钟和5分钟阿氏评分显著相关。本研究结果支持以下假设：孕期冲突可预测母亲焦虑和与压力相关的生化因素，且这些变量与产程延长和胎儿-新生儿抑郁有关。
