5075.0: Wednesday, November 15, 2000 - Board 6

Abstract #16632

Maternal psychosocial work stress and fetal development

Melissa Hawkins, MHS, Kathleen Costigan, RN, MPH, Eva Pressman, MD, and Janet DiPietro, PhD. School of Hygiene and Public Health, Johns Hopkins University, 103 W. Monument Street, Apt. 2A, Baltimore, MD 21201, 410-614-6130, mhawkins@jhsph.edu

Objectives: This study examines the impact of chronic work-related stress during pregnancy on fetal development. Stress has been shown to have detrimental effects in reproductive function across the developmental continuum. Employment issues typically constitute a significant source of psychosocial stress. If there are in fact maternal work-related effects, they may be most evident in the fetal period when the physiologic mechanisms mediating the effects are activated.

Methods: 100 women with low-risk pregnancies and their fetuses were assessed at 6 time points. With maturation, the synchrony between fetal movement (FM) and fetal heart rate (FHR) becomes more temporally associated in healthy fetuses; this association is referred to as FHR-FM coupling and represents the integrity of the cardiac and neural networks. Weighted least squares (WLS) and generalized estimating equations (GEE) were used to describe developmental trends over time in fetal coupling. The influence of maternal work-related stress on development, while controlling for potential confounding factors (maternal age, parity, and fetal sex) was also examined.

Results: FHR-FM coupling increases steadily over time (p <.001). At 20 weeks the mean coupling percentage is 16% and by 38 weeks is 34% . This increase in coupling with advancing gestation is in agreement with findings in the literature. Work related stress is negatively associated with fetal coupling. Women who report more work-related stress have fetuses with less coupling throughout pregnancy (z=-2.34, p< 0.01).

Conclusions: We suggest that maternal stress may contribute significantly to our understanding of the processes which influence fetal development during pregnancy.

Learning Objectives: At the conclusion of the session, participants will be able to: 1) describe the normative course of fetal neurobehavioral development, as represented by fetal coupling; 2) identify the relationship between maternal work related stress and fetal development; 3) discuss the contributing processes which may moderate fetal development

Keywords: Stress, Pregnancy

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA