Estresse durante a gestação como preditor de desfechos negativos

Abstract

Objective: To investigate the impact of maternal stress during pregnancy on fetal growth. Methods: a longitudinal study conducted from December 2011 to March 2013. The final sample consisted of 118 pregnant women who delivered at Santa Casa de Misericordia in Alfenas-MG. The women signed a consent form and a questionnaire was administered later. In the second and third trimesters were asked biochemical tests of cortisol, prolactin, glucose and creatinine. During the third trimester, questionnaires STAI and CES-D were applied to measure anxiety and depression, respectively. Information was collected regarding the ultrasound, weight of newborn, gestational age at which delivery took place and type of delivery. Statistical analysis was performed with software SPSS16. Data were analyzed using linear regression and logistic regression. The level of significance was 0.05. Results: The data analysis has shown that 51.9% of the women had anxious personality (a-state), 50.0% were anxious at the time of complaint (a-trace) and 73.8% had symptoms of depression. Regarding to cortisol, 32.1% had an abnormal value in second trimester and 37.1% in the third trimester. Intrauterine growth retardation occurred in 11.0% of babies born prematurely and 11.3% prevalence of low birth weight was 9.0%. The linear regression analysis showed a correlation between state anxiety and low birth weight, but it explains only 4.5% of cases. Multivariate logistic regression found an association of intrauterine growth retardation in the presence of varicose veins pregnancy (OR = 16.1) and no cramps as a protective factor (OR = .04). The low birth weight was associated with the presence of varicose veins pregnancy (OR = 13.1), coffee consumption (OR = 7.9), unstable relationship (OR = 7.9) and prematurity (OR = 15.4). Finally prematurity was associated with irregular menstrual cycles (OR = 5.4), tea consumption (OR = 12.8) and low birth weight (OR = 12.8). Conclusion: There was no association of anxiety symptoms and depression with adverse pregnancy outcomes. Variables with clinical, social and food orders were associated with intrauterine growth retardation, low birth weight and prematurity.