Effect Of Allostatic Load Of Women In The Third Trimester On The Adverse Pregnancy Outcomes

ObjectiveTo understand the allostatic load level and adverse pregnancy outcomes of women in the third trimester,explore the effect of allostatic load on adverse pregnancy outcomes,so as to provide a theoretical basis for standardizing pregnancy risk factor screening、 preventing adverse pregnancy outcomes、as well as promoting the development of maternal and child health.MethodsThis study adopted a prospective research design,convenience sampling method were used,Women in late pregnancy who underwent prenatal examination in a third A hospital、a Maternal and Child Health Hospital From November 2021 to November2022 were selected as the study subjects.In the third trimester of pregnancy(30-34 weeks of pregnancy),a questionnaire survey was conducted to collect general information,obstetric data,and depression during pregnancy.Allostatic load related data were collected by physical examination(height、weight、waist circumference、systolic and diastolic blood pressure)and laboratory tests(fasting plasma glucose、high-density lipoprotein cholesterol、total cholesterol、and hypersensitive C-reactive protein),and the allostatic load was scored and classified using the high-risk quartile method.Data on pregnancy outcomes were collected by consulting the electronic medical record system of the hospital after delivery(delivery information、 neonatal information、adverse pregnancy outcomes information).The continuous variables were described by mean ± standard deviation,and the categorical variables were described by frequency and percentage.Chi-square test was used to compare the incidence of adverse pregnancy outcomes among women with different characteristics in the third trimester.Binary multivariate logistic regression model was used to analyze the effect of allostatic load on adverse pregnancy outcomes.ResultsA total of 388 pregnant women were recruited in this study.After excluding 34 women with incomplete information on pregnancy outcomes,354 women in the third trimester were finally included.The average score of allostatic load in the third trimester was 1.93,and the high risk quartile of allostatic load was 3.The proportion of pregnant women with high level of allostatic load(AL≥3)was 32.77%.The incidence of adverse pregnancy outcomes:the average gestational age of 354 pregnant women was 38.96±1.35 weeks,cesarean section accounted for 38.70%,and vaginal delivery accounted for 61.30%.The incidence of adverse pregnancy outcomes was 14.97%(53/354),among which macrosomia was the most common 9.88%(35/354),followed by preterm birth 5.36%(19/354),low birth weight 2.25%(8/354),and preeclampsia 2.54%(9/354).Multivariate logistic regression analysis showed that women with high levels of allostatic load in the third trimester would increase the risk of adverse pregnancy outcomes(OR=2.607,95%CI:1.372,4.954)、preterm birth(OR=4.832,95%CI: 1.545,15.114)、macrosomia(OR=2.868,95%CI: 1.392,5.909)、preeclampsia(OR=7.073,95%CI: 1.407,35.553).ConclusionIn this study,women in late pregnancy have a high level of allostatic load and a high incidence of adverse pregnancy outcomes.Women with high level of allostatic load in late pregnancy will increase the risk of adverse pregnancy outcomes(preterm birth,macrosomia,preeclampsia).More attention should be paid to the allostatic load level of pregnant women and the high-risk population of adverse pregnancy should be identified early,Pregnant women can reduce chronic stress and improve stress coping ability to reduce the level of allostatic load,so as to reduce the occurrence of adverse pregnancy outcomes.