Document Detail


Pre-pregnancy stress reactivity and pregnancy outcome.
MedLine Citation:
PMID:  20955234     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Stress has been proposed as a cause of preterm birth (PTB) and small-for-gestational age (SGA), but stress does not have the same effects on all women. It may be that a woman's reaction to stress relates to her pregnancy health, and previous studies indicate that higher reactivity is associated with reduced birthweight and gestational age. The objective of this study was to examine the relationship between pre-pregnancy cardiovascular reactivity to stress and pregnancy outcome. The sample included 917 women in the Coronary Artery Risk Development in Young Adults Study who had cardiovascular reactivity measured in 1987-88 and at least one subsequent singleton livebirth within an 18-year period. Cardiovascular reactivity was measured using a video game, star tracing and cold pressor test. Gestational age and birthweight were based on the women's self-report, with PTB defined as birth <37 weeks' gestation and SGA as weight <10th percentile for gestational age. Linear and Poisson regression and generalised estimating equations were used to model the relationship between reactivity to stress and birth outcomes with control for confounders. Few associations were seen between reactivity and pregnancy outcomes. Higher pre-pregnancy diastolic blood pressure (adjusted relative risk 1.14; 95% confidence interval [CI] 0.98, 1.34) and mean arterial pressure reactivity (1.15; 0.98, 1.36) were associated with risk of PTB at first pregnancy, while SGA was associated with lower systolic blood pressure reactivity (0.76; 0.60, 0.95). No associations were seen with other measures of reactivity. Contrary to hypothesis, the association between heart rate reactivity and PTB in first pregnancy was stronger in whites (adjusted relative risk 1.39; 1.03, 1.88) than in blacks (1.00; 0.83, 1.20; P for interaction = 0.08). Similar results were found for mean arterial pressure. No strong associations were found between higher pre-pregnancy stress reactivity and SGA or PTB, and stress reactivity did not have a stronger association with birth outcomes in blacks than whites.
Authors:
Emily W Harville; Erica P Gunderson; Karen A Matthews; Cora E Lewis; Mercedes Carnethon
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2010-08-12
Journal Detail:
Title:  Paediatric and perinatal epidemiology     Volume:  24     ISSN:  1365-3016     ISO Abbreviation:  Paediatr Perinat Epidemiol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2011-01-10     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  8709766     Medline TA:  Paediatr Perinat Epidemiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  564-71     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. harville@tulane.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
African Americans / psychology,  statistics & numerical data
Birth Weight
Blood Pressure / physiology
Epidemiologic Methods
European Continental Ancestry Group / psychology,  statistics & numerical data
Female
Gestational Age
Heart Rate / physiology
Humans
Infant, Newborn
Infant, Premature
Infant, Small for Gestational Age
Pregnancy
Premature Birth / ethnology,  etiology*,  physiopathology
Stress, Psychological / ethnology,  physiopathology*
Young Adult
Grant Support
ID/Acronym/Agency:
K12 HD043451/HD/NICHD NIH HHS; K12HD043451/HD/NICHD NIH HHS; N01-HC-05187/HC/NHLBI NIH HHS; N01-HC-48047-48050/HC/NHLBI NIH HHS; N01-HC-95095/HC/NHLBI NIH HHS; N01HC48047/HL/NHLBI NIH HHS
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