TITLE:
Maternal Stress and Pregnancy Outcomes
AUTHORS:
Barthelemy Tandu-Umba, Donatien K. Dedetemo, Gilbert L. Mananga
KEYWORDS:
Maternal Stress, Maternal Outcomes, Perinatal Outcomes, Sub-Saharan Africa, DR Congo
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.7,
May
13,
2014
ABSTRACT:
Aims of
the study: To seek for magnitude of stress conditions among pregnant women, the
clinical profile of stressed pregnant women and the potential of stress on
adverse maternal and perinatal outcomes in Kinshasa. Methods: This is a multicentre 6-month
case-control study dealing with consenting women having given birth at 13
biggest maternities of Kinshasa, the capital of DR Congo. Mother-infant pairs
were considered cases (obviously stressed women) and controls (light or not
stressed women) at the end of data processing according to their perceived
stress scores (PSS). Stress events, potential stress factors and maternal
general and physical characteristics were registered along with maternal and
perinatal outcomes. Odds ratios calculation allowed finding influence of stress
on occurrence of adverse outcomes. Results and conclusions: Our study concerned 1082 women whose 57.1% (n = 618) qualified as the stressed.
General characteristics found significantly different between stressed and
non-stressed women were marital status (the married and widowed more frequent
among the stressed), instruction level (the educated more frequent among the stressed),
socioeconomic status (the elevated more frequent among the stressed) and
religion status (both the traditional and new charismatic more frequent among the
stressed). Obstetric risk factors were similar in both groups that were
different only according to stress factors, whether emotional (relationships)
or pregnancy (preciousness) related. The 3 most prominent stress factors were
parent’s death (p 0.000), tension in family (p 0.000) and tension in couple (p
0.003). All expectedly compensating factors appeared significantly more
frequent among stressed women. As of organic pregnancy
outcomes infection, gastritis, hypertensive disorders and preterm labor were
maternal ones significantly more frequent among stressed women. All non-organic
outcomes (insomnia and depression) were significantly predominant among
stressed women. In offspring, prematurity, low birth weight and
perinatal death were significantly dominant among those born to stressed women.
Odds ratios calculation showed significant potential of stress conditions on
occurrence of all maternal complications but cesarean section. In offspring
too, risk of outcomes’ occurrence was enhanced by stress, except for macrosomia
and neonatal distress.