Paarlberg K M, Vingerhoets A J, Passchier J, Dekker G A, Van Geijn H P
Department of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands.
J Psychosom Res. 1995 Jul;39(5):563-95. doi: 10.1016/0022-3999(95)00018-6.
This review focuses on the research concerning the relation between psychosocial factors and pregnancy outcome. The following four outcome measures are dealt with: (1) birth weight, (2) preeclampsia, (3) preterm labour, and (4) intrapartum complications. The most consistent finding concerns the association between maternal exposure to taxing situations and preterm delivery. Three possible pathways are hypothesized: (1) an indirect influence via unhealthy coping and life style behaviour, (2) a direct influence via stress-dependent hormones, and (3) an additional direct influence via psycho-immunological factors. Intervention studies aimed at improving pregnancy outcome show fairly mixed results. It is recommended that studies on the relationship between psychosocial factors and pregnancy outcome should employ a prospective design with due attention to chronic stressors, should include appropriate biochemical assessments, and multivariate techniques are applied.
本综述聚焦于心理社会因素与妊娠结局之间关系的研究。涉及以下四项结局指标：（1）出生体重，（2）先兆子痫，（3）早产，以及（4）分娩期并发症。最一致的研究发现是孕产妇暴露于压力情境与早产之间的关联。提出了三种可能的途径：（1）通过不健康的应对方式和生活方式行为产生间接影响，（2）通过应激相关激素产生直接影响，以及（3）通过心理免疫因素产生额外的直接影响。旨在改善妊娠结局的干预研究结果喜忧参半。建议关于心理社会因素与妊娠结局关系的研究应采用前瞻性设计，充分关注慢性应激源，应包括适当的生化评估，并应用多变量技术。
