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Wang W, Wen L, Zhang Y, Wang L, Wang L, Chen Z, Zhang L, Zhang C, Li J, Tong C, Qi H, Saffery R, Baker PN. Maternal prenatal stress and its effects on primary pregnancy outcomes in twin pregnancies. J Psychosom Obstet Gynaecol 2020; 41:198-204. [PMID: 31066336 DOI: 10.1080/0167482x.2019.1611776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective: To assess the prevalence and degrees of maternal prenatal stress among twin-pregnant women and to investigate the impact of prenatal stress on primary pregnancy outcomes.Methods: The Chongqing Longitudinal Twin Study (LoTiS) began in December 2015 in China. Participants of LoTiS who met the inclusion criteria were recruited into this study and completed a stress rating scale (PSRS) in both early and late pregnancy. Maternal prenatal stress was examined in subgroups. Correlations between maternal prenatal stress and primary pregnancy outcomes were analyzed by multivariate logistic regression.Results: A total of 215 eligible twin pregnancies from LoTiS were recruited into this study. The overall mean scores of prenatal stress were 43.41 ± 19.84 and 51.33 ± 20.43 in early and late pregnancy, respectively. The first prenatal stressor was regarding concern about the pregnancy and childbirth safety. Subgroup analyses revealed prenatal stress in late pregnancy that differed based on different pregravid BMIs and education levels. Correlation analysis suggested that the risk of preterm premature rupture of membranes increases 1.8% per unit of stress scale in late pregnancy (OR = 1.018, 95% CI 1.001-1.025).Conclusions: Prenatal stress in twin pregnancies increases with the progression of pregnancy. Higher stress in late pregnancy is associated with a higher risk of premature rupture of membranes; therefore, interventions might be essential for improving pregnancy outcomes.
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Affiliation(s)
- Wenling Wang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,The Joint International Research Laboratory of Reproduction & Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Wen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,The Joint International Research Laboratory of Reproduction & Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Zhang
- Department of Obstetrics and Gynecology, The First People's Hospital of Yuhang District, Hangzhou, China
| | - Lan Wang
- The Joint International Research Laboratory of Reproduction & Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Obstetrics, Chongqing Women and Children's Health Center, Chongqing, China
| | - Longqiong Wang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhi Chen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,The Joint International Research Laboratory of Reproduction & Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lan Zhang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chen Zhang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,The Joint International Research Laboratory of Reproduction & Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,The Joint International Research Laboratory of Reproduction & Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,The Joint International Research Laboratory of Reproduction & Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongbo Qi
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,The Joint International Research Laboratory of Reproduction & Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Richard Saffery
- Cancer, Disease and Developmental Epigenetics, Murdoch Children's Research Institute, and Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, UK
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Prenatal stress and child development: A scoping review of research in low- and middle-income countries. PLoS One 2018; 13:e0207235. [PMID: 30592715 PMCID: PMC6310253 DOI: 10.1371/journal.pone.0207235] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/27/2018] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Past research has shown relationships between stress during pregnancy, and related psychosocial health measures such as anxiety and depressive symptoms, with infant, child, and adult outcomes. However, most research is from high-income countries. We conducted a scoping review to identify research studies on prenatal stress and outcomes of the pregnancy or offspring in low- and middle-income countries (LMICs), and to synthesize the stress measures and outcomes assessed, the findings observed, and directions for future research. METHODS We searched PubMed, Scopus, and PsycINFO for English-language abstracts published from Jan 1960-Jan 2017. Search terms were related to stress and psychosocial health; pregnancy; infant or child development; and LMICs. RESULTS 48 articles were identified. Sixty percent of studies were in upper-middle, 25% in lower-middle, and 15% in low income countries. Most studies used questionnaires, either existing or tailor-made, to assess stress. Eight assessed cortisol. Most studies (n = 31) assessed infant outcomes at birth, particularly gestational age or preterm birth (n = 22, 12 showing significant relationships), and birthweight (n = 21, 14 showing significant relationships). Five studies analyzed outcomes later in infancy such as temperament and motor development, all showing significant results; and nine in childhood such as behavioral development, asthma, and physical growth, with eight showing significant results. CONCLUSIONS Results highlight the importance of prenatal stress on infant and child outcomes in LMICs. Methods used in high-income countries are successfully employed in LMICs, but tailored tools remain necessary. Careful assessment of covariates is needed to foster analyses of interactive effects and pathways. Studies including longer-term follow-up should be prioritized.
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