Stress In Pregnant Women Research Articles

Predictors of Antenatal Psychosocial Stress in Taiwanese Women.

Antenatal stress has been associated with adverse outcomes in mothers and their children. However, little research has been conducted to identify the factors associated with psychosocial stress in pregnant women. This study explored the predictors of psychosocial stress during pregnancy. A convenience sample of 136 second-trimester and 164 third-trimester pregnant women were recruited from a medical center in southern Taiwan. Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Edinburgh Prenatal Depression Scale, Pittsburgh Sleep Quality Index, Maternal-Fetal Attachment Scale, and Interpersonal Support Evaluation List. The results of this study found positive correlations between PSRS and both Edinburgh Prenatal Depression Scale (r = .368, p < .01) and Maternal-Fetal Attachment Scale (r = .168, p < .01) and negative correlations between PSRS and both gravidity (r = -.137, p < .05) and Interpersonal Support Evaluation List (r = -.266, p < .01). Higher pregnancy stress was predicted by depression, lower social support, maternal-fetal attachment, and primigravid status, which together explained 20% of the total variance. Depression, social support, maternal-fetal attachment, and gravidity are discrete predictive factors of psychosocial stress in pregnant women. These findings add to existing knowledge of the factors associated with prenatal stress. Future research should include depression in a support model of antenatal stress management.

The effect of NOx pollution on oxidative stress in pregnant women living in Durban, South Africa.

Introduction: Ambient air pollution and associated oxidative stress has been implicated in many pathological conditions; including adverse birth outcomes. Optimum glutathione-S-transferase (GST) P1 activity is essential for efficient detoxification of reactive oxygen and nitrogen species limiting DNA adduct (8-OHdG) formation. We aim to investigate the effect oxides of nitrogen (NOx) have on the induction of oxidative stress in pregnant women, and low birth weight. Method: Participants (n=113) were recruited from communities in Durban, South Africa, as part of the Mother and Child in the Environment (MACE) birth cohort. Land use regression models were developed to characterise exposure and obtain NOx levels. Serum samples were analysed for the 8-OHdG adduct using the OxiSelect™ Oxidative DNA Damage ELISA Kit. Isolated DNA from whole blood were used for single-nucleotide polymorphism (SNP) genotyping of the GSTP1 SNP using polymerase chain reaction and restriction fragment length polymorphism. Statistical data analysis included, ANOVA and student t test. Results: The 8-OHdG adduct concentration increased concomitantly with NOx (intervals 1-20, 20-40, 40-60 µg/m3: *p=0.0162). Subjects with wild type (AA) GSTP1 genotype had lower levels of 8-OHdG adducts than subjects with the variant (AG+GG) genotype at NOx 1-20µg/m3 whilst at higher NOx intervals (20-40 and 40-60µg/m3), the 8-OHdG concentration was higher for AA subjects than AG+GG (*p=0.028). Conclusion: The results show that increasing NOx levels induced increasing oxidative stress in pregnant women as observed through increased 8-OHdG adduct formation. The GSTP1 wildtype differentially influences oxidative stress with protective effects in low NOx areas and adverse effects with high NOx levels in ambient air. The effect on birth outcomes and stress markers are currently being investigated.

The Infant's Environmental Health Study (ISA) in Costa Rica: Pregnant women’s pesticide exposure and oxidative stress

Background: Occupational pesticide exposure has been associated with oxidative stress and DNA damage, a possible mechanism for cancer and neurological diseases. Only few studies have been performed in environmentally exposed populations. We studied pesticide exposure and oxidative stress in pregnant women who live nearby banana plantations. Methods: We obtained repeat urine samples (n=862) from 445 pregnant women from the ISA birth-cohort study. We measured pesticide metabolites (µg/L) for chlorpyrifos (3,5,6-trichloro-2-pyridinol (TCPy)), mancozeb (ethylene thiorurea (ETU)), pyrimethanil (hydroxy pyrimethanil (OHP), 2,4-D (2,4-D) and synthetic pyrethroids such as cypermethrin, deltamethrin and cyfluthrin (3-PBA, DCCA); as well as a biomarker for oxidative stress (8-hydroxy-2'-deoxyguanosine (8-OH-dG)). We associated log-transformed specific-gravity corrected pesticide metabolite concentrations with log-transformed specific gravity corrected 8-OH-dG (ug/L) using linear mixed-effects models. Metabolites and potential confounders were added stepwise and kept in the final model if p&lt;0.10. Gestational anemia and gestational age were included as covariates. Results: Specific gravity corrected median (25-75th percentile) metabolite concentrations were: TCPy=1.6 (1.1-2.5); ETU=3.1 (2.1- 4.8); OHP=0.4 (0.2–1.1); 2,4-D=0.3 (0.2-0.5); 3-PBA=0.7 (0.4-1.3); DCCA=1.2 (0.6-2.0) µg/L; and 8-OH-dG=4.0 (2.9; 5.3) µg/L. Increased concentrations of TCPy (β=0.08 95% CI=0.04-0.13), DCCA (β=0.09 95%CI=0.05-0.12) and OHP (β=0.02 95%CI=0.00-0.04) were associated with greater levels of urinary 8-OHdG. Conclusions: Our findings suggest chlorpyrifos, synthetic pyrethroids and pyrimethanil induce oxidative DNA-damage in pregnant women which may affect both maternal and infant’s health.

The effects of stress inoculation training on perceived stress in pregnant women.

A total of 64 pregnant women were assigned into two groups of cases and controls. Both groups filled out the Perceived Stress Scale at pre-test. Cognitive-behavioral coping skill training was delivered to the case group. After the end of the intervention, both groups completed the same scale again. The results showed that the mean perceived stress of the cases and controls was 27.77 ± 6.033 and 18.97 ± 3.268, respectively (p = 0.001). Therefore, midwives are recommended to plan educational interventions to decrease perceived stress in pregnant women.

Relationship among Periodontal Disease, Insulin Resistance, Salivary Cortisol, and Stress Levels during Pregnancy.

Pregnancy is a period involving important metabolic changes that enable the maintenance of the mother's health and development of the fetus. This study aimed to assess the relationship among periodontal disease, insulin resistance, salivary cortisol concentration and level of perceived stress in pregnant women. This was a cross-sectional study. The sample comprised 96 pregnant women between the fifth and seventh month of pregnancy registered at the Basic Health Units of the Unified Health System (SUS). The periodontal condition was assessed after obtainment free and informed consent from the participants. Participants were divided into three groups: control subjects with a healthy periodontal condition (CN; n=46), patients with gingivitis (GI; n=26), and patients with periodontitis (PI; n=24). Saliva and blood samples were collected for evaluation of salivary cortisol concentration, glycemia, insulinemia and Homeostasis Model Assessment-Insulin Resistance index. A validated survey for the assessment of perceived stress levels was also performed. PI group showed significantly higher (p<0.05) blood glucose levels (CN: 4.43±0.05; GI: 4.46±0.04; PI: 4.68±0.08), insulinemia (CN: 6.93±0.45; GI: 8.87±0.79; PI: 12.77±1.30), insulin resistance (CN: 1.40±0.10; GI: 1.81±0.18; PI: 2.66±0.29) compared with the CN and GI groups. The levels of perceived stress were higher (p<0.05) in PI and GI groups when compared to CN group (CN: 20.5±1.26; GI: 25.8±1.95; PI: 26.6±1.36). There was no significant difference in the concentration of salivary cortisol between the groups (CN: 11.13±0.58; GI: 11.96±0.74; PI: 11.47±0.74). It was concluded that there is a relationship between higher levels of perceived stress, insulin resistance and the occurrence of periodontal disease during pregnancy. This study emphasizes the importance of preventing periodontitis in order to avoid insulin resistance and stress during pregnancy since these can cause systemic complications for the mother and the fetus.

The Effect of One Month Yoga Intervention on Perceived Stress and Anxiety in Pregnant Women

The effect of one month yoga intervention on state anxiety and perceived stress in pregnant women (n=40) was examined. The participants were divided into two groups- yoga and control group. Yoga group was given one month yoga intervention of asanas, relaxation technique, pranayama, and AUM meditation (thirty minutes) for one hour every alternate day. Results indicated that yoga intervention based AUM meditation contributed significantly to reduce the perceived stress and anxiety in pregnant women.

The Effect of Cognitive Behavioural Therapy on Anxiety, Depression and Stress in Women with Preeclampsia.

Stress induced by preeclampsia in pregnancy may have a detrimental effect on both the mother and child. Risk of anxiety, depression and stress during pregnancy is, therefore, commonly associated with preeclampsia. To determine the effect of Cognitive Behavioural Therapy (CBT) on anxiety, depression and stress in pregnant women with preeclampsia. In a clinical trial, 60 women with preeclampsia were selected by the convenience sampling method from the Imam-Ali Hospital of Amol city (North of Iran). The subjects were randomly divided into two groups; the study group (n=30) and the control (n=30). All participants completed the Hospital Anxiety and Depression Scale (HADS) and a Pregnancy Distress Questionnaire (PDQ) at the beginning and end of the study. The intervention group received 12 CBT sessions lasting for 90 minutes over 4 weeks (3 sessions in a week) and the control group received no treatment. A MANCOVA test showed that CBT significantly reduced the mean scores of anxiety (5.5 ± 3.2 vs. 9.7 ± 3.8) and depression (6.4±2.6 vs 9.3±4.0) in preeclamptic women (F: 19.933, p-value <0.01). In addition, ANCOVA also revealed that CBT significantly improved the mean scores of specific-stress pregnancy (15.9 ± 6.3 vs 22.2 ± 6.8) in women with preeclampsia (F: 10.214, p-value <0.01). Psychotherapy was effective in reducing anxiety, depression and specific-stress pregnancy in pregnant women with preeclampsia.

Effect of Mindfulness Meditation on Perceived Stress Scores and Autonomic Function Tests of Pregnant Indian Women.

Various pregnancy complications like hypertension, preeclampsia have been strongly correlated with maternal stress. One of the connecting links between pregnancy complications and maternal stress is mind-body intervention which can be part of Complementary and Alternative Medicine (CAM). Biologic measures of stress during pregnancy may get reduced by such interventions. To evaluate the effect of Mindfulness meditation on perceived stress scores and autonomic function tests of pregnant Indian women. Pregnant Indian women of 12 weeks gestation were randomised to two treatment groups: Test group with Mindfulness meditation and control group with their usual obstetric care. The effect of Mindfulness meditation on perceived stress scores and cardiac sympathetic functions and parasympathetic functions (Heart rate variation with respiration, lying to standing ratio, standing to lying ratio and respiratory rate) were evaluated on pregnant Indian women. There was a significant decrease in perceived stress scores, a significant decrease of blood pressure response to cold pressor test and a significant increase in heart rate variability in the test group (p< 0.05, significant) which indicates that mindfulness meditation is a powerful modulator of the sympathetic nervous system and can thereby reduce the day-to-day perceived stress in pregnant women. The results of this study suggest that mindfulness meditation improves parasympathetic functions in pregnant women and is a powerful modulator of the sympathetic nervous system during pregnancy.

Condition of State and Trait Anxiety in Pregnant Women with Fetal Malformations

Our aim was to assess the level of state and trait anxiety, and the level of tolerated stress in pregnant women with fetus malformations. A controlled non-randomized clinical study with sequential inclusion of participants was carried out. Psychoemotional status of pregnant women was assessed by Spielberger anxiety scale, with identification of state and trait anxiety, as well as on the basis of medical history data. Pregnant women were divided into 2 groups. Control group--20 women with physiological gestation course without any fetus malformations and absence of stress situations in medical history. Main group--40 women with fetus malformations, presence of long stressful situations in medical history, starting from early gestation period. 60 women aged 20-37 years old, at the pregnancy age of 20-38 weeks were examined by ultrasound with assessment anatomy of thefetus. Comparative analysis of the psychological and emotional status of pregnant women from both groups indicated significant increase of the state and trait anxiety level in the main group of women compared to the control in the average grew from 30.80 ± 1.47 to 48.13 ± 3.84 (p < 0.001) and from 32.35 ± 1.45 to 50.25 ± 3.40 (p < 0.001) respectively. The identified high level of state and trait anxiety in pregnant women with fetus malformations allows concluding that maternal stress is a potential risk factorfor generation of intrauterine malformations of the fetus. This serves as a basis to recommend corresponding prophylactic, anti-stress measures should be taken during such pregnancy, especially at early stages, when fetus tissues formation process is taking place.

Biomarkers of nutrition and stress in pregnant women with a history of eating disorders in relation to head circumference and neurocognitive function of the offspring.

BackgroundEating disorders during pregnancy can affect fetal growth and the child’s early development, but the underlying mechanisms have not been elucidated. The aim of the present study was to investigate serum biomarkers of nutrition and stress in pregnant women with previous eating disorders compared to controls and in relation to head circumference and early neurocognitive development of the offspring.MethodsIn a longitudinal cohort study, pregnant nulliparous non-smoking women with a history of anorexia nervosa (n = 20), bulimia nervosa (n = 17) and controls (n = 59) were followed during pregnancy and their children’s growth and neurocognitive development were followed up to five years of age. We investigated maternal serum biomarkers of nutrition and stress (ferritin, cortisol, thyroid-stimulating hormone, free thyroxine, insulin, insulin-like growth factor I (IGF-I) and IGF binding protein 1) in blood samples collected during early pregnancy and compared between groups (ANOVA, LSD post-hoc test). The results were related to previous data on head circumference at birth and neurocognitive development at five years of age of the offspring (Spearman rank correlation or Pearson correlation test).ResultsSerum levels of ferritin in the women with previous anorexia nervosa, but not in those with a history of bulimia nervosa, were significantly lower than in the controls (p < 0.01), and correlated strongly to impaired memory function in their children (rs = −0.70, p < 0.001). Maternal serum levels of free thyroxine were similar between groups but correlated positively to reduced head circumference at birth of the children in the bulimia nervosa group (r = 0.48, p < 0.05), and with the same tendency in the anorexia nervosa group (r = 0.42, p = 0.07), but not in the controls (r = 0.006). There were no significant differences in cortisol or the other biomarkers between groups.ConclusionsLow maternal serum ferritin in women with previous anorexia nervosa may be of importance for impaired memory capacity in the offspring at five years of age. Our results also indicate that thyroxin levels in pregnant women with previous eating disorders are positively associated with fetal head growth.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0741-7) contains supplementary material, which is available to authorized users.

Circulating and myometrial markers of oxidative stress in pregnant women with fetal growth restriction.

The objective of this study was to identify the relationship between fetal growth restriction (FGR) and oxidative stress. The mechanisms that protect against oxidative stress in the local microenvironment were investigated by comparing the activities of the markers, both in the circulation and myometrium. Myometrial tissue and serum levels of malondialdehyde (MDA), xanthine oxidase (XO), catalase (CAT) and superoxide dismutase (SOD) markers were measured in 20 FGR and 20 healthy pregnancies. The mean duration of gestation at delivery was shorter (P = 0003) and the mean birthweight was lower P < 0001) in the FGR study group compared with the control group, as expected. While MDA and CAT concentrations were higher in the serum (P < 0.02 and P < 0.01, respectively), but lower in the myometrial samples (P < 0.01) in the FGR versus the control group, XO and myometrial SOD values were comparable in both groups. Although our data demonstrated that FGR is associated with oxidative stress, the exact role and mechanism of the oxidant and antioxidant imbalance is obscure. We speculate that despite limited local synthesis of CAT, effective and efficient removal of MDA in the uterine environment explains high MDA and CAT serum concentrations in women with FGR. Alternatively, a well-functioning myometrial system could rescue the fetus from reactive oxygen species, as demonstrated by lowered MDA and depleted CAT resulting from hyperconsumption. Elevated serum MDA and CAT levels in the serum may reflect the 'spillover' of these markers from the uterus to the circulation.

Nonylphenol exposure is associated with oxidative and nitrative stress in pregnant women

ABSTRACTAnimal studies have shown that exposure to nonylphenol (NP) increases oxidative/nitrative stress, but whether it does so in humans is unknown. This study examines prenatal exposure to NP and its effects on oxidatively/nitratively damaged DNA, lipid peroxidation, and the activities of antioxidants. A total of 146 urine and blood specimens were collected during gestational weeks 27–38 and hospital admission for delivery, respectively. Urinary NP was analyzed by high-performance liquid chromatography (HPLC). Urinary biomarkers of oxidatively/nitratively damaged DNA and lipid peroxidation, including 8-oxo-7,8-dihydro-2’-deoxyguanosine (8-oxodG), 8-nitroguanine (8-NO2Gua), 8-iso-prostaglandin F2α (8-isoPF2α) and 4-hydroxy-2-nonenal-mercapturic acid (HNE-MA), were simultaneously analyzed using isotope-dilution liquid-chromatography/electron spray ionization tandem mass spectrometry. The activities of maternal plasma superoxide dismutase and glutathione peroxidase were analyzed by enzyme-linked immunosorbent assay. Urinary NP level was significantly associated with 8-oxodG and 8-NO2Gua levels in late pregnancy, suggesting that NP may enhance oxidatively and nitratively damaged DNA. The adjusted odds ratios for high 8-oxodG level exhibited a significantly dose–response relationship with NP levels, stratified into four quartiles. 8-oxodG appears to be a more sensitive and effective biomarker of NP exposure than 8-NO2Gua. These relationships suggest NP may play a role in the pregnancy complications.

Social support for pregnant women

Abstract This paper is a review of the literature concerning the importance of social support during pregnancy. Being pregnant is a special event in every woman’s life, since it is associated with physical and mental changes. In addition to being a physiological event, pregnancy creates a burden for the body and induces stress. Pregnant women tend to suffer from fear of the unknown, especially regarding: baby, themselves, course of delivery, the need for a new role – of a mother, economic, professional, emotional situations and relationship with partner. The diagnosis of high-risk pregnancy and the need for hospitalization increase the incidence of negative emotions and experiences such as: permanent anxiety about the child’s life, anger, sadness, doubts about the diagnosis, fear of pregnancy complications, frustration and dissatisfaction with the implementation of the functions of maternal concerns during the stay in the hospital. Anxiety and fear that appear during pregnancy affect the attitude of women in pregnancy and after childbirth. Various authors frequently use the term “pregnancy-specific stress”. There is a relationship between concerns, stress in the mother during pregnancy and lifestyle, duration of pregnancy, and the possible complications during intrauterine and neonatal life. Social support significantly influences the quality of coping with stress in pregnant women. If a pregnant woman receives strong social support from her network, the negative emotions and concerns would be reduced. Receiving support also boosts the chances of successful pregnancy completion. The people from the immediate social network of a pregnant woman, like their partner, spouse, family, friends, midwife, doctor, are the most vital source of support.

Association Of Lead With Maternal Stress In Pregnant Women

Introduction: Neuro-developmental effects of in utero exposure to lead were documented in previous studies, however, limited studies focused on the association between lead exposure and maternal stress during pregnancy among pregnant women with non-occupational lead exposure. Methods: A total of 1931 pregnant women were investigated using stratified-cluster-sampling in Shanghai in 2010, and women were recruited during late pregnancy (28-36 gestational weeks). Maternal life event stress and emotional stress were assessed using “Event-Stress-Scale-for-Pregnant-Women” and “Symptom-Checklist-90-R-Scale” (SCL-90) respectively. Maternal whole blood lead concentration was determined. Other data on covariates were collected from maternal interviews and from medical records. Results: Mean maternal blood lead level was 4.33μg/dL (SD 1.71, range 0.8–14.8 μg/dL). After adjusting for potential confounders, a nonlinear relationship was observed between blood lead and total scores of SCL-90. When blood lead levels below 2.6μg/dL, the total scores of SCL-90 increased with increasing blood lead levels (β=4.19, p=0.027), however, when above 2.6μg/dL, the total scores of SCL-90 did not significantly increase with increasing blood lead levels (β=0.44 ,p=0.233), the trend difference was statistically significant (p=0.024).The similar patterns can be observed for the subscales of SCL-90 such as somatization, depression, anxiety and psychoticism. Conclusions: Our findings suggested a positive association between lead and emotional stress under low-lead-exposure conditions during pregnancy, but a non-significant association under high-lead-exposure conditions.

Markers of Oxidative Stress in Pregnant Women with Sleep Disturbances.

The quality and duration of sleep is impaired during pregnancy. Our study aimed to determine whether maternal sleep deprivation occurring during the second and third trimester of pregnancy could alter fetal well-being with respect to birth weight and APGAR score by altering the inflammatory status and oxidative stress in the mothers. . Sleep adequacy was assessed using the Pittsburgh Sleep Quality Index (PSQI). We investigated the inflammatory status and oxidative stress at term in the blood of pregnant subjects with and without sleep deprivation by measuring the levels of protein-bound sialic acid (PBSA), high-sensitivity C-reactive protein (hsCRP), malondialdehyde (MDA) and protein carbonyl (PCO). Homocysteine (Hcy) and its vitamin determinants were also measured. Fetal outcome with respect to birth weight and APGAR score were compared between study subjects. . A significant increase was observed in the levels of hsCRP, PBSA, Hcy, MDA, and PCO, in the sleep-deprived group when compared to the control group. Fetal outcome at birth showed a significant difference between the cases with high sleep deprivation and those with low sleep deprivation. . Sleep deprivation in pregnancy leads to an increase in the inflammatory parameters, oxidative stress, and Hcy levels. Fetal outcome at birth was affected more in mothers with high sleep deprivation than those with low sleep deprivation. Follow-up in these babies are needed to reveal any differences in their growth and development.

Relationship between Health Promoting Lifestyle and Perceived Stress in Pregnant Women with Preeclampsia

Lifestyle during pregnancy has long-term effects on health of mother and child. Having previous illness or unexpected maternal or fetal conditions such as preeclampsia can complicate pregnancy and interfere with health-promoting behaviors and cause stress might interfere with health-promoting behaviors. This study was carried out to examine the relationship between health-promoting lifestyles and perceived stress in women with preeclampsia. This study is a descriptive correlation design that was conducted on 182 pregnant women with preeclampsia attending in the high risk clinics of Al-Zahra and Talegani hospitals in Tabriz 2014. Data gathering tools were three: demographics, health-promoting lifestyle (HPLP-II), and perceived stress questionnaires. SPSS Ver. 13 was used for data analysis. The mean (SD) of health promoting lifestyle among pregnant women with preeclampsia was 2.4 (0.4). Among the dimensions of health promoting life style, the highest mean score was for sub domain of nutrition, i.e. 2.8 (0.5), and the lowest score was achieved by the sub-domains of physical activity, i.e. 1.5 (0.5).The mean (SD) score of perceived stress was 27.3 (7.1). There was reverse relationship between perceived stress and health -promoting behaviors. Based upon the results, health promoting behaviors were decreased by increment of perceived stress. Therefore, midwives can help women with preeclampsia by promoting health behaviors to reduce their stress and increase health-promoting behaviors.

Maternal restraint stress during pregnancy in mice induces 11β-HSD1-associated metabolic changes in the livers of the offspring.

In rats, maternal exposure to restraint stress during pregnancy can induce abnormalities in the cardiovascular and central nervous systems of the offspring. These effects are mediated by long-lasting hyperactivation of the hypothalamic-pituitary-adrenal axis. However, little is known about the potential effects of stress during pregnancy on metabolic systems. We examined the effect of restraint stress in pregnant mice on the liver function of their offspring. The offspring of stressed mothers showed significantly higher lipid accumulation in the liver after weaning than did the controls; this accumulation was associated with increased expression of lipid metabolism-related proteins such as alanine aminotransferase 2 diglyceride acyltransferase 1, peroxisome proliferator-activated receptor gamma and glucocorticoid receptor. Additionally, we observed increased levels of 11β-hydroxysteroid dehydrogenase type 1, an intercellular mediator that converts glucocorticoid from the inactive to the active form, in the foetal and postnatal periods. These results indicate that restraint stress in pregnancy in mice induces metabolic abnormalities via 11β-hydroxysteroid dehydrogenase type 1-related pathways in the foetal liver. It is therefore possible that exposure to stress in pregnant women may be a risk factor for metabolic syndromes (e.g. fatty liver) in children.

Risk Factors for Stress During Antenatal Period Among Pregnant Women in Tertiary Care Hospital of Southern India.

The well-being of an infant may be affected when the mother is subjected to psychosocial stress during her pregnancy. Mothers exposed to stressful conditions were more prone for preterm birth than those without any stress. In this study perceived stress has been used as an indicator of levels of stress. There are very few studies published from developing countries on the levels of perceived stress and its causes in pregnant women. This study employed a cross-sectional assessment of pregnant women attending the outpatient services of a tertiary care hospital for regular antenatal check-up. Women not known to have any risk factors at 28 weeks to 34 weeks of pregnancy who agreed to participate in the study were interviewed to assess the perceived stress score. Among the total patients 57.7% were primigravida and the mean score on perceived stress scale was 13.5±5.02. The majority of the group (102; 65.4%) scored higher than the mean value of total score on the perceived stress scale. Unplanned pregnancy and husband's employment status were associated with high levels of perceived stress in multivariate analysis in this set of women. Individual as well as pregnancy related factors can contribute to perceived stress in pregnant women. With the established relationship between maternal mental health, pregnancy outcome and infant growth, the assessment and management of stress early in the pregnancy is crucial.

Perceived Social Support and Stress among Pregnant Women at Health Centers of Iran- Tabriz.

Social support is considered the interaction between the person and environment, which reduces stressors, covers the effects of stress and consequently protects individuals from the harmful effects of stressful situations. This study aimed to determine social support in pregnant women and its relationship with the rate of pregnant women's perceived stress at health centers of Tabriz in 2012-13. This cross-sectional study was carried out on 450 pregnant women selected through cluster sampling. Data collection tools consisted of a demographic questionnaire, interpersonal support evaluation list (ISEL) and perceived stress questionnaire (PSS) that were completed in an interview. The range of obtainable score for social support and perceived stress was 0-90 and 0-30, respectively. Descriptive and analytical statistics including Pearson and Independent t-test were used for analyzing the data. The mean score of social support and perceived stress in pregnant women was 96.6 (14.6), and 11.5 (5.5), respectively .The women with favorable social support had significantly less stress than the women with unfavorable social support. The study finding showed that the rate of social support in highly stressful women is significantly less than low-stress mothers. Therefore, considering adverse effects of the stress on pregnancy outcomes, some strategies should be designed and implemented in order to strengthen and improve the social support for pregnant women so that it can reduce the rate of pregnant women's stress.

Urinary phthalate metabolites and biomarkers of oxidative stress in pregnant women: a repeated measures analysis.

BackgroundPhthalate exposure occurs readily in the environment and has been associated with an array of health end points, including adverse birth outcomes. Some of these may be mediated by oxidative stress, a proposed mechanism for phthalate action.ObjectivesIn the present study, we explored the associations between phthalate metabolites and biomarkers of oxidative stress measured in urine samples from multiple time points during pregnancy.MethodsWomen were participants in a nested case–control study of preterm birth (n = 130 cases, n = 352 controls). Each was recruited early in pregnancy and followed until delivery, providing urine samples at up to four visits. Nine phthalate metabolites were measured to assess exposure, and 8-hydroxydeoxyguanosine and 8-isoprostane were also measured in urine as markers of oxidative stress. Associations were assessed using linear mixed models to account for intraindividual correlation, with inverse selection probability weightings based on case status to allow for greater generalizability.ResultsInterquartile range increases in phthalate metabolites were associated with significantly higher concentrations of both biomarkers. Estimated differences were greater in association with monobenzyl phthalate (MBzP), mono-n-butyl phthalate (MBP), and monoisobutyl phthalate (MiBP), compared with di(2-ethylhexyl) phthalate (DEHP) metabolites.ConclusionsUrinary phthalate metabolites were associated with increased oxidative stress biomarkers in our study population of pregnant women. These relationships may be particularly relevant to the study of birth outcomes linked to phthalate exposure. Although replication is necessary in other populations, these results may also be of great importance for a range of other health outcomes associated with phthalates.CitationFerguson KK, McElrath TF, Chen YH, Mukherjee B, Meeker JD. 2015. Urinary phthalate metabolites and biomarkers of oxidative stress in pregnant women: a repeated measures analysis. Environ Health Perspect 123:210–216; http://dx.doi.org/10.1289/ehp.1307996