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Stress: Pregnancy Considerations

Cardwell, Michael S. MD, JD, MPH, MBA

Obstetrical & Gynecological Survey: February 2013 - Volume 68 - Issue 2 - p 119–129
doi: 10.1097/OGX.0b013e31827f2481

Stress-induced pregnancy complications represent a significant cause of maternal and perinatal morbidity and mortality due to preterm labor, low-birth-weight babies, pregnancy-induced hypertension, and neuropsychological developmental delays of affected offspring. Psychosocial factors such as socioeconomic status, work status, marital status, level of education, access to prenatal care, substance abuse, ethnicity, cultural background, and quality of relationships with partners and parents have been identified as determinants of stress during pregnancy. The biopsychosocial model of health and disease aptly explains the interactions of these psychosocial factors in the genesis of stress-induced pregnancy complications. Prenatal screening and intervention for relevant biopsychosocial risk factors may be useful in preventing stress-related perinatal complications.

Target Audience: Obstetricians and gynecologists, family physicians

Learning Objectives: After completing this CME activity, physicians should be better able to describe how stress is manifested biologically, discuss stress and its impact from the biopsychosocial model of health and disease, recognize how stress may lead to pregnancy complications such as preterm labor, preeclampsia, and low-birth-weight infants, explain how stress may impact the neuropsychological development of children whose mothers experienced perinatal stress, and demonstrate how prenatal screening and appropriate interventions may reduce perinatal stress and associated pregnancy complications.

Associate Professor, Department of Obstetrics & Gynecology, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commerical organizations pertaining to this educational activity.

Correspondence requests to: Michael S. Cardwell, MD, JD, MPH, MBA, Department of Obstetrics & Gynecology, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, 4801 Alberta Ave, El Paso, TX 79905. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.