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Stress and Blood Pressure During Pregnancy



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Stress and Blood Pressure During Pregnancy Racial Differences and Associations With Birthweight CLAYTON J HILMERT PHD CHRISTINE DUNKEL SCHETTER PHD TYAN PARKER DOMINGUEZ PHD MPH MSW CLEOPATRA ABDOU MA CALVIN J HOBEL MD LAURA GLYNN PHD AND CURT SANDMAN PHD Objective To extend findings that African American women report greater stress during pregnancy have higher blood pressure BP and are twice as likely to have low birthweight infants relative to white women This study examines a racial differences in associations between stress and BP during pregnancy and b the combined effects of stress and BP on infant birthweight in a sample of 170 African American and white women Methods A prospective longitudinal study of pregnant women was conducted in which measures of BP stress and other relevant variables were collected Multiple measures of systolic and diastolic BP were taken at each of three points during pregnancy 18 20 24 26 and 30 32 weeks gestation Results Both systolic blood pressure SBP and diastolic blood pressure DBP were positively associated with stress in pregnant African American women and not in pregnant white women In analyses of birthweight there were no main effects of BP or stress However a significant interaction demonstrated that when stress was high DBP was negatively associated with birthweight and a combination of high stress and high DBP predicted the lowest birthweight in the sample Furthermore African American women were twice as likely as white women to have a combination of high stress and high DBP Conclusions Racial differences in relationships between stress and BP and the interactive effect of stress and DBP on birthweight together suggest that a high stress high BP profile may pose a risk for lower birthweight among African American women in particular and possibly for all pregnant women Key words pregnancy birthweight African American blood pressure stress BP blood pressure DBP diastolic blood pressure SBP systolic blood pressure BMI body



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