COMMENTARY

Psychological Stress During Pregnancy May Kill the Fetus


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This is the Medscape Medical Minute. I'm Dr. George Lundberg.

Stress is difficult to define and measure, but some believe it is important to health. Four authors in Denmark studied whether "psychological stress" during pregnancy may have an outcome on the pregnancy and reported the results in the BJOG in 2008.[1] They used the 12-item General Health Questionnaire to measure low, intermediate, and high psychological stress between 1989 and 1998 in 19,282 singleton pregnancies. There were 66 stillbirths defined as delivery of a dead fetus after 28 weeks of gestation. Women with a high level of stress had an 80% increased risk of stillbirth over those with an intermediate level of stress, after adjusting for maternal age, parity, BMI, smoking, alcohol and caffeine use, education, and cohabitation. Exclusion of complications, such as diabetes, hypertension, vaginal bleeding, and immunization, did not alter the result. Don't ask me how or why, but psychological stress during pregnancy is apparently associated with increased risk of stillbirth.

This article was selected from Medscape Best Evidence.[2] I'm Dr. George Lundberg.


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