title: Association between antenatal distress and uterine artery pulsatility index.
abstract: Although studies have found associations between maternal distress/anxiety and alterations in blood flow, data across different trimesters are inconsistent. We, therefore, sought to determine the association between measures of distress and uterine blood flow in all three trimesters. Healthy women with low-risk singleton pregnancies were recruited from antenatal clinics. Women were assessed at 13-14 weeks (T1), 21-22 weeks (T2), and 32-33 weeks (T3) of gestation with measures of distress and anxiety (the K10, Perceived Stress Scale, and the State Subscale of the Spielberger State-Trait Anxiety Inventory [STAI]) and with uterine Doppler flow velocity studies. The Trait Subscale of the STAI was done either at T1 or T2. Thirty women were seen at T1, 79 women were seen at T2, and 59 women were seen at T3. No significant correlations were found between measures of distress and anxiety and umbilical artery pulsatility index (PI) or middle cerebral artery PI at any time-point. Small positive correlations between trait anxiety and uterine artery PI were found, but these were not significant after adjustment for alcohol and nicotine use (any use as well as problem drinking/nicotine dependence). At T3 but not T1 or T2, women scoring above 20 on the K10 (a standardized cutoff for the presence of axis I psychiatric disorders) had higher uterine artery PI than those scoring below 20.This was significant after adjusting for alcohol and nicotine use, as well as when nicotine dependence was considered. This work highlights the complexities of the relationship between increased measures of distress and anxiety and changes in the placental circulation. Further work in this area is needed to explore the underlying mechanisms which account for this relationship and to delineate fully the extent to which the relationship is determined by the presence of psychiatric and substance use disorders.
authors.affiliation: Department of Psychiatry (J-Block), Groote Schuur Hospital, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa. bavanisha.vythilingum@uct.ac.za
authors.forename: Bavanisha
authors.initials: B
authors.lastname: Vythilingum
authors.forename: Lut
authors.initials: L
authors.lastname: Geerts
authors.forename: Dylan
authors.initials: D
authors.lastname: Fincham
authors.forename: Annerine
authors.initials: A
authors.lastname: Roos
authors.forename: Sheila
authors.initials: S
authors.lastname: Faure
authors.forename: Johanna
authors.initials: J
authors.lastname: Jonkers
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications* / Q000503:physiopathology; D001783:Blood Flow Velocity; D015331:Cohort Studies; D005260:Female; D005333:Fetus / Q000098:blood supply*; D005865:Gestational Age; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology* / Q000523:psychology; D011256:Pregnancy Outcome; D011673:Pulsatile Flow; D013732:Test Anxiety Scale; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000098:blood supply / Q000000981:diagnostic imaging; D055988:Uterine Artery / Q000000981:diagnostic imaging; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging; D055815:Young Adult