Da Costa D, Brender W, Larouche J
Department of Clinical Epidemiology, Montreal General Hospital, Quebec, Canada.
J Psychosom Obstet Gynaecol. 1998 Mar;19(1):28-37. doi: 10.3109/01674829809044218.
This prospective study examines the influence of maternal stress, social support and lifestyle variables reported over the course of pregnancy on subsequent gestational and intrapartum complications. Demographic and biomedical factors were also studied. One hundred and two women were followed on a monthly basis beginning in the third month of pregnancy. Measures of daily stress (hassles), state-anxiety (STAI-state) and pregnancy-specific stress were taken monthly. Pregnancy progress and lifestyle behaviors such as smoking, caffeine and alcohol intake were assessed by trimester. One month following delivery, a telephone interview was conducted to inquire about the labor/delivery and infant status. Sixty-three per cent of the women experienced a pregnancy complication. Three groups consisting of women who experienced gestational complications, intrapartum complications only, and no complications were formed. Women who subsequently experienced gestational complications reported over the course of their pregnancy higher levels of state-anxiety, daily hassles and pregnancy-specific stress beginning in the third month of pregnancy. Women who experienced complications during the intrapartum period only reported higher daily hassles during pregnancy and consumed more caffeinated beverages compared to the other groups. Primiparous women were more likely to experience gestational and/or intrapartum complications than multiparous women. These findings support a role for psychosocial variables in pregnancy complications. The results indicate that certain psychosocial and lifestyle variables may be differentially associated with complications occurring at various phases of pregnancy.
这项前瞻性研究考察了孕期报告的母亲压力、社会支持和生活方式变量对随后的孕期及分娩期并发症的影响。还研究了人口统计学和生物医学因素。从怀孕第三个月开始，每月对102名女性进行随访。每月测量日常压力（烦心事）、状态焦虑（状态-特质焦虑量表状态分量表）和特定于怀孕的压力。按孕期评估怀孕进展和生活方式行为，如吸烟、咖啡因和酒精摄入量。分娩后一个月，进行电话访谈以询问分娩情况和婴儿状况。63%的女性经历了怀孕并发症。将女性分为三组，分别是经历孕期并发症的女性、仅经历分娩期并发症的女性和未经历并发症的女性。随后经历孕期并发症的女性在整个孕期报告，从怀孕第三个月开始，其状态焦虑、日常烦心事和特定于怀孕的压力水平更高。仅在分娩期经历并发症的女性在孕期报告的日常烦心事更多，且与其他组相比饮用了更多含咖啡因的饮料。初产妇比经产妇更有可能经历孕期和/或分娩期并发症。这些发现支持心理社会变量在怀孕并发症中起作用。结果表明，某些心理社会和生活方式变量可能与怀孕各阶段发生的并发症存在不同关联。
