COMPLICATIONS LINKED TO STRESS IN PREGNANCY.

Byline: Denise Mann Medical Tribune News Service

Pregnant women who experience stress, either on the job or at home, are more likely to develop complications during their pregnancies than women who are able to cope better, two new reports suggest.

In one study of 717 working pregnant women, those with lower-status jobs who had little control over their work were more than twice as likely to develop high blood pressure than pregnant women who had more control over their workload, according to researchers at the Cornell University Medical College in New York City.

In another study of 5,834 pregnant women, Danish researchers found that those who were exposed to stressful life events and perceived them as stressful were 76 percent more likely to give birth prematurely than women who were able to take the stress in stride.

Both studies, which appeared in the July issue of the journal Epidemiology, add to the growing body of evidence linking psychological stress with a host of physical problems, including pregnancy complications and heart disease.

Although exactly how stress can lead to high blood pressure during pregnancy or premature labor is not clearly understood, elevated levels of stress-induced hormones - such as corticotropin-releasing hormone - most likely play a role in triggering both conditions, according to lead author Dr. Paul A. Landsbergis of the Hypertension Center at the Cornell University Medical College.

In the Cornell study, all working pregnant women were at an increased risk for developing pregnancy-induced high blood pressure.

Not only did women with low-status jobs who had little control over their work show an increased risk of the condition, but women with higher-status jobs who had little control over their schedules showed more than triple the risk of developing high blood pressure compared with women who said they had a lot of control over their schedule.

``If you look at the big picture, stress will frequently be associated with contractions, preterm labor and the onset of preeclampsia,'' said Dr. Richard Paul, professor of obstetrics and gynecology at the University of Southern California School of Medicine in Los Angeles.

Preeclampsia is a condition marked by very high blood pressure, swollen ankles and protein in the urine. The condition can lead to problems with the placenta and low birth weight.

If a pregnant woman has to work for the majority of her pregnancy, ``employers should provide 30-minute or hour breaks so she can lie down on her side because periods of enforced rest and nonstress are a good prescription for these patients,'' Paul suggested. Work breaks are even more important if a woman is working in a job that requires her to stand up all day long.

In the Danish study, the 207 women who gave birth before term reported coping poorly with stressful life events such as arguments with a partner, an increased number of family arguments or death and sickness in the family.

``Life events subjectively assessed as highly stressful occurring during the second and early third trimester decrease duration of pregnancy and increase risk of preterm delivery,'' wrote lead author Dr. Morten Hedegaard of the department of obstetrics and gynecology at the Aarhus University Hospital in Denmark.

``The main thing is to point out that stress can cause'' complications in pregnancy, because if women become more conscious of the link between the two, ``they can try and work on mechanisms to avoid confrontation,'' Paul suggested.