title: Psychosocial predictors of fetoplacental blood flow during pregnancy.
abstract: BACKGROUND
  Although a number of studies have found significant associations between maternal psychological distress, anxiety and changes in fetoplacental blood flow, findings remain inconsistent. A recent pilot study by our group highlighted some of these inconsistencies. In the current study, we expanded this pilot analysis to include psychological distress, anxiety and a range of antenatal variables, with the aim of identifying predictors of fetoplacental blood flow.
  
  
  METHODS
  Healthy pregnant women (n=148) underwent Doppler flow studies on uterine, umbilical and fetal arteries; as well as assessments of distress, anxiety and other antenatal variables (e.g. perceived social support, resilience, nicotine and alcohol use) in each trimester.
  
  
  RESULTS
  Stepwise regression analyses found that state anxiety was associated with lower mid-cerebral artery pulsatility index at trimester 3.
  
  
  CONCLUSIONS
  Subjects were recruited from selected midwife obstetric units in the same health district, so the generalizability of our results may be limited. While most subjects received Doppler assessment at trimesters 2 and 3, only approximately half of our sample was assessed at trimester 1.
  
  
  CONCLUSIONS
  The finding that anxiety is associated with increased blood flow to the fetal brain during trimester 3 of pregnancy, coincide with previous work. The findings emphasize a growing appreciation of the potential importance of psychological well-being during pregnancy for infant development. However, as associations were small and variable, further research using multivariate models to determine the precise mechanisms underlying these associations would be warranted.
authors.affiliation: SU/UCT MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, Stellenbosch University, PO Box 19063, Tygerberg 7505, South Africa. Electronic address: aroos@sun.ac.za.
authors.forename: A
authors.initials: A
authors.lastname: Roos
authors.affiliation: Department of Obstetrics & Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Geerts
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, J-Block Groote Schuur Hospital, Observatory, Cape Town, South Africa.
authors.forename: N
authors.initials: N
authors.lastname: Koen
authors.affiliation: SU/UCT MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, Stellenbosch University, PO Box 19063, Tygerberg 7505, South Africa.
authors.forename: S C
authors.initials: SC
authors.lastname: Faure
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, J-Block Groote Schuur Hospital, Observatory, Cape Town, South Africa.
authors.forename: B
authors.initials: B
authors.lastname: Vythilingum
authors.affiliation: SU/UCT MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, Stellenbosch University, PO Box 19063, Tygerberg 7505, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, J-Block Groote Schuur Hospital, Observatory, Cape Town, South Africa.
authors.forename: D J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D001007:Anxiety / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D010865:Pilot Projects; D010920:Placenta / Q000000981:diagnostic imaging; D021041:Placental Circulation / Q000502:physiology*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011569:Psychiatric Status Rating Scales; D055500:Resilience, Psychological; D012907:Smoking / Q000009:adverse effects; D012944:Social Support; D013315:Stress, Psychological / Q000503:physiopathology; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055815:Young Adult