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Obstetrical & Gynecological Survey:
doi: 10.1097/OGX.0000000000000009
CME Articles

Association Between Mental Stress and Gestational Hypertension/Preeclampsia: A Meta-Analysis

Zhang, Shanchun MD, PhD*; Ding, Zheyuan MD; Liu, Hui MD; Chen, Zexin MD; Wu, Jinhua MD; Zhang, Youding MD§; Yu, Yunxian MD, PhD*

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Background: Hypertensive disorders of pregnant women are one of the important causes of maternal and perinatal morbidity and mortality. Evidence showed mental stress might be a risk factor of gestational hypertensive disorders.

Objective: The objective of this study was to evaluate the relationships between mental stress and gestational hypertension/preeclampsia in pregnant women.

Methods: Relevant studies were identified by PubMed, Cochrane, Chinese medical datasets (Wanfang, CNKI, and VIP Database). Only case-control or cohort studies evaluating an association of preeclampsia or gestational hypertension with mental stress were included in the present meta-analysis. Essential information was extracted from the qualified studies. Odds ratio (OR) was used as a pooled effect size. Potential heterogeneity and publication bias were detected as well.

Results: Thirteen studies were included in the final analyses, which totally recruited 668,005 pregnant women. The results indicated that mental stress was associated with an increased risk of gestational hypertension (OR, 1.26; 95% confidence interval [CI], 1.00–1.59; P = 0.047) and preeclampsia (OR, 1.49; 95% CI, 1.27–1.74; P < 0.001). Meanwhile, work stress (OR, 1.50; 95% CI, 1.15–1.97; P = 0.003) and anxiety or depression (OR, 1.88; 95% CI, 1.08–3.25; P = 0.02) were positively associated with risk of preeclampsia.

Conclusions: Mental stress during life or pregnancy may be a risk factor for gestational hypertension and preeclampsia among pregnant women.

Target Audience: Obstetricians and gynecologists, family physicians

Learning Objectives: After completing this CME activity, physicians should be better able to evaluate the mental stresses that put patients at risk for preeclampsia and gestational hypertension, identify risk factors for preeclampsia and gestational hypertension, and determine possible measures to prevent preeclampsia and related conditions.

© 2013 by Lippincott Williams & Wilkins.


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