title: Association between mental stress and gestational hypertension/preeclampsia: a meta-analysis.
abstract: BACKGROUND
  Hypertensive disorders of pregnant women are one of the important causes of maternal and perinatal morbidity and mortality. Evidence showed mental stress might be a risk factor of gestational hypertensive disorders.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the relationships between mental stress and gestational hypertension/preeclampsia in pregnant women.
  
  
  METHODS
  Relevant studies were identified by PubMed, Cochrane, Chinese medical datasets (Wanfang, CNKI, and VIP Database). Only case-control or cohort studies evaluating an association of preeclampsia or gestational hypertension with mental stress were included in the present meta-analysis. Essential information was extracted from the qualified studies. Odds ratio (OR) was used as a pooled effect size. Potential heterogeneity and publication bias were detected as well.
  
  
  RESULTS
  Thirteen studies were included in the final analyses, which totally recruited 668,005 pregnant women. The results indicated that mental stress was associated with an increased risk of gestational hypertension (OR, 1.26; 95% confidence interval [CI], 1.00-1.59; P = 0.047) and preeclampsia (OR, 1.49; 95%CI, 1.27-1.74; P < 0.001). Meanwhile, work stress (OR, 1.50; 95% CI, 1.15-1.97; P = 0.003) and anxiety or depression (OR, 1.88; 95%CI, 1.08-3.25; P = 0.02)were positively associated with risk of preeclampsia.
  
  
  CONCLUSIONS
  Mental stress during life or pregnancy may be a risk factor for gestational hypertension and preeclampsia among pregnant women.
authors.affiliation: Associate Professor, Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Shanchun
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Medical Student, Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Zheyuan
authors.initials: Z
authors.lastname: Ding
authors.affiliation: Medical Student, Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.affiliation: Medical Student, Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Zexin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Associate Chief Physician, Zhoushan Maternal and Child Health Hospital, Zhoushan, Zhejiang, China.
authors.forename: Jinhua
authors.initials: J
authors.lastname: Wu
authors.affiliation: Chief Physician, Zhoushan Maternal and Child Health Hospital, Zhoushan, Zhejiang, China.
authors.forename: Youding
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Associate Professor, Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Yunxian
authors.initials: Y
authors.lastname: Yu
mesh_terms: D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology* / Q000523:psychology; D011225:Pre-Eclampsia / Q000209:etiology* / Q000523:psychology; D011247:Pregnancy; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*