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• W250919928 abstract "ABSTRACT: The purpose of this study was to assess the possible contribution of psychosocial factors to birth outcome, through prospective assessment prior to delivery. Four hundred, eighty-six consecutive pregnant women in their first or second trimester were enrolled along with their partners; interviews were conducted with the benefit of physiological monitoring and a variety of psychological measurements. Seven categories of psychosocial variables emerged with stability and reliability. Two psychological factors-fear of birth and support from the woman's partner-most strongly discriminated between the uncomplicated and complicated birth outcome groups. The authors conclude that psychosocial factors do influence birth complications and attention to reducing their impact could potentially improve birth outcome. Obstetrical care providers should no longer ignore these factors. INTRODUCTION Psychosocial factors, such as stress, anxiety, fear, and lack of social support, may increase obstetrical risk.1 Realistic, accurate social support during pregnancy may facilitate a healthier birth outcome.2 Smilkstein, Helsper-Lucas, Ashworth, Montano and Pagel3 have provided the Cycle of Psychosocial Risk Model which conceptualizes the effects of psychosocial factors on prenatal health and disease. In Smilkstein's model, multiple stressors impact upon an individual each day. A response is generated reflecting the individual's cognitive appraisal of the stressor. The Tilack box' within which cognitive appraisals are made is the individual's belief system. Beliefs are influenced by many factors, including the person's past experience with similar stressors. Beliefs represent the results of prior learning. Smilkstein notes that the cognitive appraisal process is affected by the person's psychosocial equilibrium at the time the stressor is received and by the number and intensity of other stressors being processed by the person. Once past the point of abortion, pregnancy is an irresolvable stress. After this point of no return, birth and parenthood cannot be prevented, though many women may choose not to conceive or may terminate their pregnancy after conception. Once the decision to keep the pregnancy is made (consciously or unconsciously), adjustment and therefore anxiety is inevitable. Anxiety is inherent in change. Anxiety can be minimal and manageable or can be intense and disruptive. We wondered if women having more social support would suffer less physiological impact from anxiety and therefore experience more uncomplicated labors? Decreasing support for the family in current conditions of urban mobility is increasing the stress of pregnancy and parenthood.2 Today's ambiguity and inherent contradictions in woman's role in society may increase medical risk for childbearing.4 The struggle to integrate career and motherhood can be intense for women whose own mothers served as negative role models. We know that stress affects children. The probability of children's adjustment difficulties rises with the number of family stressors.6 Cumulative family adversity differentiated secure from insecure infants among a sample of 100 low-income families, but only when three or four stressors were present.6 Stressors included parental criminality, maternal depressive symptomatology, maternal personality risk, overcrowding in the home, and the quality of the relationship of the parents with each other. Waters, Vaughn, and Egeland7 suggest that neonatal difficulties interact with difficult environments to produce anxious attachments and other behavioral problems. But could stress affect the actual physical outcome of birth? Meta-analysis of studies on maternal emotion, stress, and birth outcome8 does support a relationship between psychosocial variables and birth outcome. The most methodologically acceptable studies show significant links of the emotional state of the expectant mother to habitual abortion, hyperemesis gravidarum, toxemia, deviant infant behavior, and a variety of pregnancy and birth complications. …" @default.
• W250919928 created "2016-06-24" @default.
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• W250919928 date "2002-10-01" @default.
• W250919928 modified "2023-09-22" @default.
• W250919928 title "Psychosocial Variables Predict Complicated Birth" @default.
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