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Wiley InterScience

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 115 Issue 5, Pages 607 - 615

Published Online: 7 Mar 2008

Journal compilation © 2010 RCOG



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Is psychosocial stress in first ongoing pregnancies associated with pre-eclampsia and gestational hypertension?
KC Vollebregt, a MF van der Wal, b H Wolf, a TGM Vrijkotte, c K Boer, a GJ Bonsel c
  a Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, the Netherlands   b Municipal Health Services, GGD Amsterdam, Amsterdam, the Netherlands   c Department of Social Medicine, Academic Medical Center, Amsterdam, the Netherlands
Correspondence to  KC Vollebregt, Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, the Netherlands. Email k.c.vollebregt@amc.uva.nl
Copyright Journal compilation © RCOG 2008 BJOG An International Journal of Obstetrics and Gynaecology
KEYWORDS
Hypertensive disorders of pregnancy • pre-eclampsia • psychosocial stress

ABSTRACT

Objective Investigating the association of pre-eclampsia and gestational hypertension with psychosocial stress in the first half of pregnancy.

Design Prospective community-based cohort study.

Setting Amsterdam, The Netherlands.

Population Between January 2003 and March 2004, all pregnant Amsterdam women (n = 12 377) were invited to fill in a questionnaire with sociodemographic and psychosocial variables (response rate 67%). Only nulliparous women with a singleton pregnancy, who completed the questionnaire before 24 weeks, and delivered after 24 weeks, were included.

Methods A postpartum questionnaire was used to gather information on hypertension or proteinuria. If this questionnaire was not available, the national obstetric register was used for pregnancy outcome. Medical files were examined for women with hypertension and/or proteinuria to confirm the diagnosis of pre-eclampsia and gestational hypertension according to the International Society for the Study of Hypertension in Pregnancy guidelines. Psychosocial stress was defined as workstress (Work Experience and Appreciation Questionnaire partly based on the Job Content Instrument of Karasek et al.), anxiety (the State-Trait Anxiety Inventory), depression (Center for Epidemiological Studies Depression Scale) and pregnancy-related anxiety (PRAQ-R). The association of psychosocial stress with the incidence of pre-eclampsia and gestational hypertension was explored by multivariate analysis adjusted for sociodemographic and medical confounders.

Main outcome measures Incidence of pre-eclampsia and gestational hypertension.

Results A total of 3679 women were included. The incidence of pre-eclampsia and gestational hypertension was 3.5 and 4.4%, respectively. Workstress, anxiety, pregnancy-related anxiety or depression had no effect on the incidence of pre-eclampsia or gestational hypertension.

Conclusion Psychosocial stress in the first half of pregnancy does not influence the incidence of pre-eclampsia and gestational hypertension in nulliparous women.


Accepted 21 December 2007.

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1471-0528.2008.01665.x About DOI

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