Male Violence, Stress, and Neuroendocrine Parameters in Pregnancy: A Pilot Study

Comparing Perceived Social Support and Perceived Stress in Healthy Pregnant Women and Pregnant Women with Preeclampsia

Background

Preeclampsia is a prevalent side effect of pregnancy. Different studies have reported different results about the relationship between mental stress and blood pressure disorders. In addition, social support is highly important to help women who experience risky pregnancy in adapting to the stressors they experience. This study aimed to compare perceived social support and perceived stress in women with and without preeclampsia.

Methods and Materials

Fifty pregnant women definitely diagnosed with preeclampsia and 50 healthy pregnant women visiting public hospitals including Hazrat Masoumeh, Motazedi, and Imam Reza in Kermanshah-Iran took part in a descriptiveanalytical study from June 2017 to January 2018. Data gathering tools included demographics questionnaire, social support appraisals scale and perceived stress scale. The collected data was analyzed with SPSS (v.20) using independent t-test.

Results

The mean score of perceived social support in the preeclampsia and non-preeclampsia groups were 69.88±7.3 and 76.80±7.6 respectively (P<0.01). The mean score of perceived stress in the preeclampsia and non-preeclampsia groups were 35.6±8.7 and 26.01±5.56 respectively (P<0.01). This means that compared with healthy women, women with preeclampsia perceived more stress and less social support.

Conclusion

In comparison with healthy pregnant women, women with preeclampsia perceived more stress and less social support. Healthcare providers should recommended to pay more attention to improving social support and attenuating stress in pregnant women.

The psychobiology of stress and intimate partner violence

Exposure to intimate partner violence (IPV) negatively affects health outcomes, however, the biopsychosocial pathways underlying this relationship are not well understood. We conducted a systematic review of research published from 2000 through 2018 on biological and psychological stress-related correlates and consequences of IPV exposure. Fifty-three publications were included. The biological and psychological literatures have evolved separately and remain distinct. The biological literature provides emerging evidence of stress-related endocrine and immune-inflammatory dysregulations that are in line with patterns typically observed among chronically stressed individuals. The psychological literature provides strong evidence that IPV is associated with psychological stress, and that psychological stress follows new instances of IPV. Larger scale, integrative studies using prospective study designs are needed to more carefully map out how IPV influences victims both biologically and psychologically, and how these biopsychological changes, in turn, affect the health of victims over time.

Conceptualization, measurement, and effects of pregnancy-specific stress: review of research using the original and revised Prenatal Distress Questionnaire

Pregnancy-specific stress (PSS) arises from the numerous changes that women experience during pregnancy and from their concerns about childbirth and the health of their offspring. Prolonged or elevated maternal stress heightens risk for poor fetal, infant, and child outcomes. The Prenatal Distress Questionnaire (PDQ) and its expanded successor, the revised Prenatal Distress Questionnaire (NuPDQ), were developed to assess PSS, but their psychometric properties and findings are not well-documented. We reviewed research using the PDQ (n = 45) or NuPDQ (n = 37). Results establish that PSS as measured by these instruments is common in pregnancy; PSS is associated with sociodemographic and obstetric characteristics, perceptions of pregnancy, health behaviors, maternal health, and birth outcomes. The NuPDQ is an especially appropriate tool to assess PSS, with demonstrated reliability and convergent, concurrent, and predictive validity. The ability to assess PSS in a reliable and valid manner is critical to advance research and improve maternal and child health.

Mediated Effects of Coping on Mental Health Outcomes of African American Women Exposed to Physical and Psychological Abuse

Few studies have assessed the individual symptoms of posttraumatic stress disorder (PTSD) as separate mental health consequences of intimate partner abuse (IPA). This study examined the role of coping strategies associated with symptoms of PTSD in a community sample of African American women who have experienced abuse ( N = 128). The results revealed that nonphysical abuse was more prevalent than physical abuse. Specific symptoms of PTSD expressed depended on the type of abuse experienced and the type of coping strategies utilized. The findings have multiple implications on how IPA is studied as well as its clinical screening and treatment processes.

An Exploratory Study Using Cortisol to Describe the Response of Incarcerated Women IPV Survivors to MAMBRA Intervention

Objective. To determine if incarcerated women survivors of IPV had a physiological response to the Music and Account-Making for Behavioral-Related Adaptation (MAMBRA) intervention, as measured by cortisol levels. Methods. A single-group repeated measures designed exploratory study was used to pilot-test MAMBRA. A convenience sample (n = 33) was recruited in a Midwestern women's correctional facility. Serving as their own control, participants provided demographics and pre-/post-MAMBRA salivary samples while attending four MAMBRA sessions. Baseline data were compared to participants' data collected over the remaining 3 MAMBRA sessions. Data were analyzed with descriptive and univariate statistics with an alpha of .05 and post-hoc power of .65. Results. Participants were predominantly White (52%), single (80%), and early middle-aged (x-AGE=38.7±9.4), with a history of physical/nonphysical spousal abuse. Using a subsample (n = 26), salivary cortisol decreased between the pre-/post-MAMBRA over the sessions (F(3,75) = 4.59, p < .01). Conclusion. Participants had a physiological response to the MAMBRA intervention as evidenced by the decreased cortisol between the pre-/post-MAMBRA. This is the first step in examining MAMBRA's clinical utility as an intervention for female IPV survivors. Future longitudinal studies will examine MAMBRA's effectiveness given this change in cortisol.

Lifetime Exposure to Intimate Partner Violence and Proinflammatory Cytokine Levels Across the Perinatal Period

BACKGROUND

Intimate partner violence (IPV) is a public health concern, affecting one-third of US women. Prior research suggests an association between exposure to IPV and poor maternal perinatal health, but the underlying biological correlates are not well understood. This study examined the relationship between exposure to IPV and proinflammatory cytokine levels, a candidate mechanism accounting for poor psychiatric and obstetric outcomes, across the perinatal period.

MATERIALS AND METHODS

Data were obtained from a prospective, longitudinal cohort study of 171 women receiving obstetrical care from a hospital-based practice serving a predominantly low-income minority population. Participants completed questionnaires on IPV exposure, psychiatric symptoms, and psychosocial and obstetric factors and provided blood samples at 18 and 32 weeks of gestation and 6 weeks and 6 months postpartum. Serum levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) were assayed via enzyme-linked immunosorbent assay.

RESULTS

Thirty-five (20.5%) women reported lifetime exposure to IPV and 7 (4.1%) reported being physically hurt in the preceding 12 months (4 while pregnant). Lifetime exposure to IPV was associated with increased likelihood of experiencing perinatal depression and smoking during pregnancy. Women with a history of IPV had significantly higher levels of TNF-α at 18 weeks (z = -2.29, p < 0.05), but significantly smaller changes in levels of IL-6 (β = -0.36, p = 0.04) across time.

CONCLUSION

Lifetime exposure to IPV was associated with a range of adverse mental health outcomes and may affect proinflammatory cytokine levels in pregnancy.

Violence during pregnancy: associations with pregnancy intendedness, pregnancy-related care, and alcohol and tobacco use among a representative sample of New Zealand women

AIM

To explore the extent of intimate partner violence during pregnancy and its association with pregnancy intendedness and pregnancy-related behaviours among a representative sample of New Zealand women.

METHODS

Face-to-face interviews were conducted with a representative sample of 2391 women who had ever been pregnant, aged 18-64 years old in two regions (urban and rural) in New Zealand.

RESULTS

Six per cent of urban women and 9% of rural women had ever experienced violence during pregnancy; approximately 40% of these had experienced violence in more than one pregnancy. Women who had experienced violence in pregnancy, compared with those who had not, were less likely to report their last pregnancy had been wanted at that time (28% vs 55%), and less likely to report that their partner wanted the pregnancy (40% vs 57%). Antenatal and postnatal care attendance was almost universal during the last pregnancy. Women who had experienced violence during pregnancy were more likely to smoke tobacco during pregnancy (67% vs 22%, P < 0.0001), and more commonly, consumed alcohol (31% vs 20%, not significant). For the most recent pregnancy in which women had experienced violence, most was perpetrated by the child's biological father (96%), and most women (74%) reported that the same man had also beaten her before she was pregnant.

CONCLUSIONS

Violence during pregnancy is a significant problem for New Zealand women, with negative health implications for both women and their children. Active intervention and support is necessary to mitigate potential consequences.

Stress and preterm labor and birth in Black women

OBJECTIVE

To examine (a) 3 commonly used measures of stress during pregnancy, (b) changes in stress over time to determine when stress is highest, and (c) whether any of the stress measures predict who will deliver preterm in pregnant Black women.

DESIGN

Prospective descriptive study.

SETTING

Perinatal evaluation center and outpatient clinics of a teaching hospital in the northeast.

PARTICIPANTS

Fifty-nine Black women: 39 were recruited in preterm labor from a Perinatal Evaluation Center, and 20 experiencing healthy pregnancies were recruited from the prenatal clinic.

MEASURES

Stress was measured using 2 paper and pencil tests (the Prenatal Distress Questionnaire and the Perceived Stress Scale) and corticotropin-releasing hormone.

RESULTS

There was not a high correlation between stress measures. Stress at 28 weeks as measured by Prenatal Distress Questionnaire and Perceived Stress Scale was at its highest, but corticotropin-releasing hormone increased to 32 weeks and then decreased.

CONCLUSIONS

Perceived stress, prenatal distress, and corticotropin-releasing hormone do not all appear to be measuring the same phenomenon. Screening for stress in Black women at 28 weeks requires further research as perceived stress levels in Black women experiencing preterm labor around 28 weeks differentiated women who delivered preterm infants from Black women who delivered at term.

Comparative analyses of stressors experienced by rural low-income pregnant women experiencing intimate partner violence and those who are not

OBJECTIVE

To describe the daily lives of rural pregnant women who smoked during pregnancy, with a focus on their sources of stress and the compounding effects of intimate partner violence.

DESIGN

A qualitative study using content analysis of research nurses' telephone logs from a large smoking cessation randomized controlled trial (N=695) in which 33% of the sample (n=227) experienced intimate partner violence in the past year.

PARTICIPANTS

Fifty pregnant women, 25 who had experienced intimate partner violence in the past year and 25 who had never experienced intimate partner violence, were randomly selected from those who received a nurse-delivered telephone intervention for smoking cessation (n=345). The mean age of the sample was 22 years, and the majority were White and living in a married-like relationship.

RESULTS

Women experiencing intimate partner violence discussed certain stressors significantly more often than nonabused women. These stressors included finances, lack of social support, legal issues, transportation issues, and abuse by the intimate partner and others.

CONCLUSION

Health care providers need to recognize that intimate partner violence creates a stress, which can compound the stressors of pregnancy and poverty in rural areas. Offering these women a chance to talk about their lives can help them not only to locate necessary resources, but also to break down the barriers of isolation.

Endogenous opiates and behavior: 2006

This paper is the 29th consecutive installment of the annual review of research concerning the endogenous opioid system, now spanning 30 years of research. It summarizes papers published during 2006 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurological disorders (Section 11); electrical-related activity and neurophysiology (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration and thermoregulation (Section 16); and immunological responses (Section 17).

Intimate partner violence and the childbearing year: maternal and infant health consequences

Intimate partner violence (IPV) against women is a significant public health problem with negative physical and mental health consequences. Pregnant women are not immune to IPV, and as many as 4% to 8% of all pregnant women are victims of partner violence. Among pregnant women, IPV has been associated with poor physical health outcomes such as increased sexually transmitted diseases, preterm labor, and low-birth-weight infants. This article focuses on the physical health consequences of IPV for mothers and their infants. The purpose of this review is therefore to examine timely research ranging from 2001 to 2006 on IPV during pregnancy, the morbidity and mortality risks for mothers and their infants, and the association between IPV and perinatal health disparities. It will also identify gaps in the published empirical literature and make recommendations for practice, policy, and research.