Hedegaard M, Henriksen T B, Secher N J, Hatch M C, Sabroe S
Department of Obstetrics and Gynaecology, Aarhus University Hospital, Denmark.
Epidemiology. 1996 Jul;7(4):339-45. doi: 10.1097/00001648-199607000-00001.
The present study was designed to test the relation between stressful life events experienced during pregnancy and the risk of preterm delivery and shortened duration of pregnancy. We collected data prospectively in a general population sample, including repeated questionnaire measures of exposure to stressful life events during pregnancy. Between August 1989 and September 1991, 8,719 Danish-speaking women with singleton pregnancies attended antenatal care. Of these women, 5,873 (67%) completed all questionnaires. When indicating an event, the woman was asked to rate the amount of stress induced by this event. Measurement of gestational duration was primarily based on early ultrasound scan. When we evaluated life events independently of the individual's appraisal, we found no association with duration of gestation or risk of preterm delivery. In contrast, life events assessed by the subject as highly stressful were associated with shorter mean duration of gestation and increased risk of preterm delivery. This association was observed primarily with events experienced between the 16th and 30th week of gestation. Women who had one or more highly stressful life events had a risk of preterm delivery 1.76 times greater than those without stressful events (95% confidence interval = 1.15-2.71). We found no evidence for a buffering effect of social support.
本研究旨在测试孕期经历的应激性生活事件与早产风险及孕期缩短之间的关系。我们在一个普通人群样本中前瞻性地收集数据，包括对孕期接触应激性生活事件的重复问卷调查。1989年8月至1991年9月期间，8719名单胎妊娠的丹麦语女性接受了产前护理。其中，5873名（67%）女性完成了所有问卷。当指出某一事件时，要求该女性对该事件所引发的应激量进行评分。孕期时长的测量主要基于早期超声扫描。当我们独立于个体评估来评估生活事件时，未发现其与妊娠期时长或早产风险有关联。相比之下，被受试者评估为高度应激的生活事件与较短的平均妊娠期及增加的早产风险相关。这种关联主要在妊娠第16至30周期间经历的事件中观察到。有一个或多个高度应激生活事件的女性早产风险比没有应激事件的女性高1.76倍（95%置信区间=1.15 - 2.71）。我们没有发现社会支持具有缓冲作用的证据。
