Assess the Stress: Identifying Psychosocial Risk to Optimize Perinatal Outcomes in Military Gravids

摘要

Pregnancy is a dynamic event that results in physiological, psychological, sociological, and developmental changes (Logsdon, 2000; Norbeck & Tilden, 1983). This can lead to stress, which directly and indirectly affects maternal and fetal well being. Complications occur in approximately 50% of all pregnancies of healthy adult women in North America (DaCosta, Brender, & Larouche, 1998). Despite medical advances, the incidence of pregnancy complications has changed little since the 1960's (DaCosta, Dritsa, Larouche, & Brender, 2000). Preterm birth and low birth weight are the two most recognized complications of maternal stress in pregnancy, and are the number one cause of neonatal mortality and morbidity (Blecher, 2001). Although extensive research has been conducted over the past 30 years validating the link between psychosocial factors and perinatal outcomes, little attention is given to these in the perinatal setting. Obstetrical providers are still relying on biomedical and demographic information alone to determine perinatal risk. Women in the military are a vulnerable population at risk for antepartum, intrapartum, and postpartum complications (Magann & Nolan, 1991; Rosen & Evans, 2000). The lack of social support due to geographic separation from family, friends, and often times, partners, seems to be contributory to their risk. This is significant since studies have shown that social support can buffer the detrimental effects of stress.