Neuroendocrine response to violence during pregnancy--impact on duration of pregnancy and fetal growth.
OBJECTIVE
To study the neuroendocrine release of cortisol in response to perceived stress among pregnant women exposed to partner violence and how this affects the duration of pregnancy and the intrauterine growth of the infant.


METHODS
Cross-sectional community-based study.


METHODS
Health and Demographic Surveillance System of Leon, Nicaragua.


METHODS
One-hundred and forty-seven pregnant women.


METHODS
Standardized scales to measure intimate partner violence, social resources, perceived stress, and socio-economic conditions were applied. Two salivary samples for cortisol were collected in the morning and afternoon on the same day. Linear regression and path analysis were used.


METHODS
Cortisol levels, gestational age, and weight at delivery.


RESULTS
Partner violence during the pregnancy, low social resources, and perceived maternal stress were associated with high level of salivary cortisol. Pregnant women with high cortisol levels were significantly more likely to give birth to small-for-gestational age babies, but not to deliver preterm. A substantial decrease of birthweight, 121-186 g, was associated with an increase in cortisol in association with violence exposure.


CONCLUSIONS
Partner violence during pregnancy is a stressor that provokes high levels of cortisol, which is associated with reduction of birthweight.
Valladares
Eliette
E
Department of Obstetrics and Gynecology, National Autonomous University of Leon, Leon, Nicaragua. eliette.valladares@epiph.umu.se
Peña
Rodolfo
R
Ellsberg
Mary
M
Persson
Lars Ake
LA
Högberg
Ulf
U
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D047109:Fetal Development; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009527:Nicaragua / Q000453:epidemiology; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000378:metabolism*; D011795:Surveys and Questionnaires; D014754:Violence
D006854:Hydrocortisone