Abstract

Background

Stress-induced pregnancy complications are thought to represent a significant cause of maternal morbidity and mortality; little is known regarding types of stress most predictive of adverse outcomes.

Methods

We used Utah PRAMs 2012–2014 data to evaluate links between preconception life stressors and prevalence of hypertensive disorders of pregnancy (HDP) and pre-term labor (PTB) (births <37 weeks gestational age, and very PTB <33 weeks). We categorized 12 specific stressful events into 4 groups: partner, traumatic, financial, and emotional. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated controlling for important sociodemographic, lifestyle, and pregnancy history factors.

Results

4,378 mothers completed the survey. 26.6%, 12.2%, 32.2%, and 28.4% reported partner, traumatic, financial, and emotional-related stress. Reporting any of the 4-types of life stress was linked with increased prevalence of HDP (aPR: 1.46 [95% CI: 0.96, 2.22]) after adjusting for age, race/ethnicity, BMI, education, prior diagnosis of high blood pressure, and prior history of preterm labor. The strongest association was observed for financial stress (aPR: 1.50 [95% CI: 1.03, 2.18]). Financial stress was also associated with increased prevalence of very PTB (aPR: 1.61 [95% CI: 1.03, 2.51]) after adjustment.

Conclusion

Women reporting financial stress, including job loss, pay reduction, or difficulty paying bills, had increased prevalence of HDP and very PTB.

中文翻译：

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生活压力源、妊娠高血压疾病和早产

摘要

背景

压力引起的妊娠并发症被认为是孕产妇发病率和死亡率的重要原因；关于最能预测不良结果的压力类型知之甚少。

方法

我们使用犹他州 PRAMs 2012-2014 数据来评估孕前生活压力因素与妊娠期高血压疾病 (HDP) 和早产 (PTB) 患病率之间的联系（出生小于胎龄 37 周，非常 PTB <33 周）。我们将 12 种特定的压力事件分为 4 组：伴侣、创伤、财务和情绪。调整后的患病率 (aPRs) 和 95% 置信区间 (CIs) 是在控制重要的社会人口学、生活方式和妊娠史因素的情况下估计的。

结果

4,378 位母亲完成了调查。26.6%、12.2%、32.2% 和 28.4% 的人报告了与伴侣、创伤、财务和情绪相关的压力。在调整年龄、种族/民族、BMI、教育程度、高血压的先前诊断后，报告 4 种生活压力中的任何一种都与 HDP 患病率增加有关（aPR：1.46 [95% CI：0.96, 2.22]）和早产的既往史。观察到财务压力的关联性最强（aPR：1.50 [95% CI：1.03, 2.18]）。调整后，财务压力也与非常 PTB 的患病率增加有关（aPR：1.61 [95% CI：1.03, 2.51]）。

结论

报告财务压力（包括失业、减薪或难以支付账单）的女性 HDP 和 PTB 患病率增加。