| Abstrakt: |
Pregnancy is associated with the physical and emotional stress that results in physiological and psychological changes. Stress during pregnancy can increase the risk of postpartum depression. The postpartum psychiatric disorders among mothers often remain undiagnosed and untreated. An appropriate quantitative tool that predicts maternal postnatal psychological status during the antenatal period will be of concern in reproductive health. The study assessed maternal psychological stress during antenatal (>32 weeks of pregnancy) and the postnatal period (>6 weeks after delivery). The study also evaluates the role of prenatal stress markers in the prediction of postnatal maternal psychological health. This is a longitudinal study involving thirty-five healthy pregnant women with a singleton pregnancy in the age group of 25–35. Maternal psychological stress was assessed using physiological (Heart rate variability), biochemical (saliva cortisol, hair cortisol) markers, and perceived stress scale (WHOQOL-BREF) during the antenatal and postnatal period. The perceived stress scores were significantly higher during the postnatal period (p = 0.04) compared with antenatal period, which indicates a better quality of life in the postnatal period. Saliva cortisol level, a marker of acute stress, was significantly higher during the prenatal period (p < 0.001). Also, a cardiac autonomic marker of psychological stress, as assessed by HRV measures, shows that HF spectral power was lower (p = 0.000) and LF spectral power, LF/HF significantly higher (p = 0.000) during the antenatal period when compared with the postnatal period. There was a significant positive correlation between prenatal maternal HRV measures like HF spectral power (p-0.01), negative correlation between LF/HF (p = 0.02) and postnatal stress scores. Prenatal HRV parameter like HF spectral power shows a significant negative correlation with postnatal EPDS scores (0.000). Also, there is a significant positive correlation between LF spectral power, LF/HF, and postnatal EPDS scores (0.001). The study concludes that maternal psychological stress was significantly higher during the prenatal period when compared to the postnatal period. In contrast to biochemical stress markers, the prenatal maternal cardiac autonomic marker can be an independent predictor of postnatal maternal psychological health. [ABSTRACT FROM AUTHOR] |
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