title: Neuroendocrine response to violence during pregnancy--impact on duration of pregnancy and fetal growth.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, National Autonomous University of Leon, Leon, Nicaragua. eliette.valladares@epiph.umu.se
authors.forename: Eliette
authors.initials: E
authors.lastname: Valladares
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Peña
authors.forename: Mary
authors.initials: M
authors.lastname: Ellsberg
authors.forename: Lars Ake
authors.initials: LA
authors.lastname: Persson
authors.forename: Ulf
authors.initials: U
authors.lastname: Högberg
mesh_terms: 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
chemical_list: D006854:Hydrocortisone