Stress And Preterm Labor
The beginning of labor is a complex process that is not fully understood. Multiple hormones and body systems in both mother and baby are involved, and predicting when labor will start is very difficult. Because labor is complicated and hard to study, scientists can’t say for sure that stress causes preterm labor.
However, there is an association. In other words, studies show that mothers who experience more stress are more likelyto go into labor early, so stress increases a mother’s risk of premature labor. During stressful situations, the body reacts in a number of ways. For instance, heart rate and blood pressure increase, and hormones flood the body.
It’s important to realize that stress can be either acute or chronic.
- With acute stress, the body’s reaction is temporary and short-lived. Afterward, the body returns to its normal state.
- With chronic stress, whatever is bothering you is ongoing or recurs. As a result, the body never returns to its normal state.
Acute stress does not increase the chances that a mother will go into preterm labor. If you have, say, an occasional argument with your baby’s father or have trouble paying the bills sometimes, you’re not at higher risk. However, the changes that chronic stress makes to the body are what doctors think might contribute to preterm labor.
Emotional Stress During Pregnancy
With so many changes happening to your body during your nine months of pregnancy, the emotional upheaval that comes with those changes including those pregnancy hormones that do a number on your moods, making stress harder to handle all the prep work necessary for babys arrival and the worry about labor and delivery, its no wonder youre feeling just a tad bit stressed while you’re pregnant.
Feeling stressed is extremely common, and par for the pregnancy course. Plus, not all stress is bad, and some stress may even be good, since it helps you get through challenging times and keeps you on your toes so youre motivated to take the best possible care of yourself and your baby-to-be.
Can Stress During Pregnancy Cause Autism
You might want to take a few deep breaths before you read this.
It seems like almost every day researchers are pointing the finger at something as a possible cause of autism spectrum disorder . Now the latest in a long line of culprits is apparently stress during pregnancy.
We already know maternal stress has been linked to a bunch of unwelcome outcomes like pre-term delivery and low birth weight not to mention an increase in behavioral problems in kids later in life. But a 2016 study in the New England Journal of Medicine tells us that being stressed out while pregnant may cause autism, too.
“We know that some mothers who experience significant levels of stress don’t have children with autism, but others do,” explained senior author of the study, David Beversdorf, M.D. “Autism was thought to be largely a genetic disorder, but previous research has shown that environmental influences such as stress can play an important role in the development of the condition.”
Their findings? The moms of kids with ASD who had the variation reported feeling more stress during the end of the second and the beginning of the third trimester of pregnancy. Yikes!
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How Can I Get Help
If you feel anxious or depressed, talk to a doctor, counselor, or therapist, and get help right away. The sooner treatment starts, the sooner you’ll feel better.
Also talk to a doctor about your overall health and any mental health issues you’ve had in the past. It’s best for your doctor to know your full medical history, in case anything comes up during or after your pregnancy.
Do Individuals Respond Differently To Stress
Each of us finds different tasks or situations stressful. A task that one person finds enjoyable can be highly stressful to another. Each individual also reacts differently to an event perceived as stressful. There appear to be distinct differences in how our bodies respond to stress, and some of these differences may have an impact on pregnancy.
James McCubbin, PhD, and other researchers at the University of Kentucky College of Medicine measured pregnant womens blood pressure following a stressful arithmetic task. All of the women had normal blood pressure readings prior to the task. This 1996 study reported that women with larger diastolic blood pressure increases were more likely to have smaller-than-average or low-birth-weight babies and premature babies. The researchers speculate that increased levels of stress-related hormones may affect both maternal blood pressure and fetal growth and development. Studies like this one suggest that it may eventually be possible to identify a group of women who are at risk of preterm labor and of having a low-birthweight baby, and provide stress-reduction techniques to help reduce their risk.
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The Effects Of Prenatal Stress On Child Behavioural And Cognitive Outcomes Start At The Beginning
Vivette Glover, MA, PhD, DSc
Institute of Reproductive and Developmental Biology, Imperial College London, United Kingdom
The importance of development during the fetal period is well established with regards to the association between the babys growth in the womb, and later vulnerability to physical disorders such as cardiovascular disease and other aspects of metabolic syndrome.1 It is now clear that environmental effects on fetal development are important with respect to emotional, behavioural and cognitive outcomes too. Animal studies have shown that stress during pregnancy can have long lasting effects on the neurodevelopment of the offspring.2
Subject and Research Context
Many groups around the world are studying how the emotional state of the mother during pregnancy can have long-lasting effects on the psychological development of her child.3-4 Some are using large population cohorts, which have the advantage of being able to statistically allow for many confounding factors including postnatal maternal mood.5 Others are smaller observational studies which can examine the child in more detail.6 Stress is a generic term which includes anxiety and depression, but also includes distress due to poor relationships or the response to an acute disaster. All these have been shown to be associated with altered outcome for the child.
Key Research Questions
Recent Research Results
Implications for Parents, Services and Policy
Whats The Difference Between Baby Blues And Postpartum Depression
The baby blues is a mild form of postpartum depression that many new moms experience. It usually starts 1 to 3 days after the birth and can last for 10 days to a few weeks. With baby blues, many women have mood swingshappy one minute and crying the next. They may feel anxious, confused, or have trouble eating or sleeping. Up to 80% of new moms have the baby blues. Its common, and it will go away on its own.
About 13% of new mothers experience postpartum depression, which is more serious and lasts longer. You are at a greater risk if you have a family history of depression or have had depression before.
Some of the symptoms include:
- feeling like you cant care for your baby,
- extreme anxiety or panic attacks,
- trouble making decisions,
- hopelessness, and
- feeling out of control.
No one knows exactly what causes postpartum depression. If you think you have the symptoms, its important to get help right away. Postpartum depression needs to be treated. Talk to your doctor or call your local public health office.
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Affect And Low Birth Weight
Recent evidence points more often to the role of maternal depressive symptoms in the etiology of LBW as compared with the etiology of PTB . The recent meta-analysis on depression in pregnancy, cited earlier, evaluated 20 studies and found that high depressive symptoms were associated with 1.4 to 2.9 times higher risk of LBW in undeveloped countries, and 1.2 times higher risk on average in the USA . Another recent review found relatively large effects of maternal depressive symptoms on infant birth weight across several studies, with the largest effects for low-income or low social status women and women of color . Furthermore, although there are few studies on diagnosed disorders, one study reported that mothers with a depressive disorder had 1.8 times greater risk of giving birth to a LBW infant . Thus, evidence appears to be stronger for contributions of depressive symptoms or disorder to slower growth of the fetus and LBW than to the timing of delivery or PTB, and these effects are pronounced for disadvantaged women . In contrast, very few studies have demonstrated any effects of anxiety on LBW, with rare exceptions .
Be Careful But Dont Panic
Sudden mood changes or prolonged anxiety arent trivial. They can have serious health consequences. Your body will let you know when you have built up stress or tension. Maybe you arent sleeping well, youre overworked, or youre having problems at home or at school. Youre stressed because, on top of all that, you have a tiny life growing inside of you.
Nevertheless, its important to point out that sudden, unexpected events that cause stress arent dangerous. For example, if a barking dog startles a pregnant woman.
The situations that matter are those that imply some kind of prolonged threat, loss, or damage. These kinds of situations can harm the baby in utero. Its also important to keep in mind that each woman reacts emotionally different in similar situations. Consequently, stress wont affect every woman in the same way.
Make sure to get enough rest and dont be too hard on yourself. Deal with problems step-by-step, eat right, and get enough exercise. Follow your doctors instructions. All of these things will help you avoid stress during pregnancy.
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Concentrate On Your Breathing
Stress can have a major effect on your breathing. It can cause you to take shorter, shallower breaths which decrease the oxygen in your body. This shallow breathing, in turn, can cause your stress levels to rise as your body reacts to the lack of oxygen. Yes, its a vicious cycle, but you can take control by focusing on your breathing and meditating.When you feel yourself getting stressed, sit or lie down, close your eyes, and take at least five deep breaths. Breathe in through your nose and out through your mouth while paying attention to the rise and fall of your chest. As you breathe, try to relax and let your stress slip away.
Can Stress During Pregnancy Cause Miscarriage
Depending on whom you ask, stress during pregnancy is either a risk factor for miscarriage and stillbirthor it’s an outright myth that stress has any relation to pregnancy loss. The role of stress in pregnancy is a complicated one.
Some evidence does support the idea that stress could affect a pregnancy. But the evidence is mixed, and many doctors and health authorities say that stress is not a contributing factor for miscarriage.
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How Can Stress Affect My Baby And Me
Some people might also experience:
- obsessive thoughts
- eating problems
- trouble relaxing or winding down
Chronic stress could also cause problems for your baby. These can include effects on your unborn babys growth and the length of gestation . They can also increase the risk of problems in your babys future physical and mental development, as well as behavioural issues in childhood.
How Can A Pregnant Woman Reduce Stress
Each pregnant woman needs to identify the personal and work-related sources of stress in her life and develop effective ways to deal with them. Any woman, whether pregnant or not, can cope better with the stresses in her life if she is healthy and fit.
A pregnant woman should eat a healthy diet, get plenty of sleep, avoid alcohol, cigarettes and drugs and exercise regularly . It is important that a pregnant woman not skip meals because the fetus needs constant nutrition, and long fasts put stress on a womans body. She should eat three meals plus at least two healthy snacks, or five to six small meals a day. Exercise keeps pregnant women fit, helps prevent some common discomforts of pregnancy and relieves stress.
Having a good support network which can include the pregnant womans partner, extended family, friends and others also helps a pregnant woman relieve stress. These individuals may provide information, emotional support or help with tasks around the home. Some studies suggest that having good support actually may reduce the risk of preterm labor and low birthweight, especially for poor, high-risk women or women who are feeling stressed.
Dr. McCubbin has developed a simple relaxation plan that any pregnant woman can use:
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Clinical Screening For Affective Symptoms In Pregnancy
Clinical screening for depression or anxiety in prenatal and postpartum healthcare has been widely recommended but is also potentially problematic. The issues concern what screening tools to use what cutoffs to adopt for identifying women at risk the need for expert clinicians to follow up on those women who score above thresholds to make diagnoses and, for those who have established diagnoses, the availability of affordable and efficacious treatments . These issues must be resolved for prenatal clinical screening to be recommended widely. For example, the EPDS, which is a gold standard used widely in clinic settings for depression screening both prepartum and postpartum, actually measures both depressive and anxiety symptoms, which may contribute to confusion about risks . In addition, experts have questioned the validity of a diagnosis of depressive disorders using standard diagnostic criteria for mood disturbance because they include typical somatic symptoms of pregnancy such as fatigue, sleep disturbance, and appetite changes . Also relevant is one recent study reporting that women with both depression and anxiety disorders were at highest risk of LBW, as compared with those with only depressive or anxious symptoms or none . Combinations of symptoms have received very little research attention. Furthermore, little research thus far has examined the feasibility and utility of screening for prenatal stress or pregnancy anxiety.
Effects Of Stress During Pregnancy
While some stress is normal and healthy, too much stress or unchecked stress can affect your health, your pregnancy and even your baby.
For instance, if you have high levels of stress, you may turn to unhealthy coping mechanisms, like drinking alcohol, smoking, drugs or unhealthy eating.
Too much stress can also lead to anxiety and/or depression mental health conditions that could impact your pregnancy and your general well-being.
High levels of stress can also exacerbate any chronic conditions you have, as well as make you more susceptible to illnesses. And if your stress levels remain high for a long time say throughout your pregnancy and beyond it could possibly lead to high blood pressure and heart disease.
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Prenatal Emotional Stress Index
The Prenatal Emotional Stress Index is a self-report questionnaire assessing emotional stress during pregnancy . It was applied at the first measurement time to assess maternal emotional stress during pregnancy. retrospectively. The questionnaire consists of 11 items per pregnancy trimester measuring anxiety, sadness, joy, stress, and tension via visual analogous scales ranging from 0 to 100%. The scale values are the mean item responses per trimester. Cronbachs was = 0.91 for the first, = 0.92 for the second and = 0.93 for the third trimester, indexing excellent internal consistency. Average scores were M = 31.92 for the first, M = 30.41 for the second and M = 31.63 for the third trimester. The intercorrelations between pregnancy trimesters were as follows: the first trimester significantly correlated with the second and third trimester as well as the second trimester correlated significantly with the third trimester . A composite score averaged over the three trimesters was used for the analyses This composite score reached an excellent internal consistency and ranged from min = 2.42 to max = 86.97 .
How Are Problems Treated
Treatment for mental health problems may include:
- Prescription medicine. Always talk to a doctor before you start taking or stop taking any medicines during your pregnancy. If you take any kind of medicine for a mental health issue and are pregnant or planning to get pregnant, tell your doctor. Don’t stop taking it unless your doctor tells you to. Some medicines may cause problems for a growing baby, but stopping your medicine may make things worse. Your doctor can make a treatment plan that is best for you and your baby.
- Talk therapy. Talking one-on-one with a therapist can be a great way to manage stress, deal with depression, and ease anxiety during pregnancy. Finding a support group where you can share your concerns with other mothers who know what you’re going through also can help. Talking with a social worker or counselor can help you deal with money issues, worries over raising a child, or other stresses in your life.
- Other approaches. Many women find comfort in activities like yoga, exercise, and meditation. If you’re feeling stressed or overwhelmed, talking to a friend, family member, or faith leader can help you feel better.
Many moms feel anxious or depressed at some point in their pregnancy, and some may even need treatment for it. But a mental health problem doesn’t have to be a problem for you or your baby. Get the help you need to feel better, and you’ll be doing the best thing for you both.
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