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      Evaluación de estrés percibido y niveles de alfa-amilasa salival en mujeres embarazadas (del Municipio Libertador del Estado Mérida)

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          Abstract

          Objetivo: Investigar la percepción del estrés en mujeres embarazadas y su interrelación con los niveles de la enzima alfa amilasa salival (AAS) que es un marcador biológico de estrés. Métodos: Incluimos 38 embarazadas que acudían a la consulta prenatal en Centros de Salud del Municipio Libertador del Estado Mérida, Venezuela. Se distribuyeron en 3 grupos de acuerdo con la edad gestacional, 8 en el primer trimestre, 10 en el segundo, 10 en el tercer y como grupo control se tomaron 10 mujeres no embarazadas con características demográficas similares. El estrés percibido se midió a través del instrumento EEP-13 y el nivel de enzima alfa amilasa salival mediante ensayo enzimático con espectrofotometría. Con los puntajes del EEP-13, se establecieron tres niveles de estrés percibido. Resultados: El 23,7 % de la muestra tenía niveles bajos de estrés percibido, 50 % poseía un nivel intermedio y la cuarta parte (26,3 %) mostró un nivel alto. No se encontró relación significativa entre el nivel de estrés percibido y la etapa del embarazo (P = 0,637). La concentración de enzima alfa amilasa salival fue significativamente mayor en el grupo de embarazadas en el primer trimestre en comparación con el control (P<0,001), sin embargo, no encontramos correlación entre la puntuación del EEP-13 (R²=0,014; P=0,81) y los niveles de enzima alfa amilasa salival. Conclusión: El 76,3 % de este grupo de embarazadas mostró niveles significativos de estrés según el EEP-13 y solo el grupo de embarazadas en el primer trimestre mostró niveles de enzima alfa amilasa salival superiores al grupo control.

          Translated abstract

          Objective: To assess the levels of salivary alpha amylase enzyme (SAA) that is a biomarker of stress and the correlation of those levels with the perception of stress in pregnant women. Methods: Thirty eight pregnant women who attended prenatal care clinics in the Libertador Municipality of Merida, Venezuela, were distributed in 3 groups according with the gestational age: 8 on the first trimester, 10 on the second and 10 on the third. The control group consisted of 10 non-pregnant women with similar demographic characteristics. The perceived stress was measured with the EEP-13 instrument and the level of SAA was determined by means of an spectrophotometric enzymatic assay. Three levels of perceived stress were established according to the score obtained by the EEP-13 test. Results: Twenty three percent (23.7 %) of the pregnant women had low levels of perceived stress, 50 % had an intermediate level and 26.3 % showed a high level. No significant relationship between the level of perceived stress and the age of pregnancy was found (P=0.637). The SAA concentration was significantly higher in the group of pregnant women in the first trimester compared to the non-pregnant control group (P <0.001). No correlation between the EEP-13 test values of perceived stress and the enzyme concentration was found (R2=0.014; P=0.81). Conclusion: In this group of pregnant women, 76.3 % suffer from a significant amount of stress and only the pregnant women in the first trimester showed increased levels of SAA.

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          Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice.

          To briefly review results of the latest research on the contributions of depression, anxiety, and stress exposures in pregnancy to adverse maternal and child outcomes, and to direct attention to new findings on pregnancy anxiety, a potent maternal risk factor. Anxiety, depression, and stress in pregnancy are risk factors for adverse outcomes for mothers and children. Anxiety in pregnancy is associated with shorter gestation and has adverse implications for fetal neurodevelopment and child outcomes. Anxiety about a particular pregnancy is especially potent. Chronic strain, exposure to racism, and depressive symptoms in mothers during pregnancy are associated with lower birth weight infants with consequences for infant development. These distinguishable risk factors and related pathways to distinct birth outcomes merit further investigation. This body of evidence, and the developing consensus regarding biological and behavioral mechanisms, sets the stage for a next era of psychiatric and collaborative interdisciplinary research on pregnancy to reduce the burden of maternal stress, depression, and anxiety in the perinatal period. It is critical to identify the signs, symptoms, and diagnostic thresholds that warrant prenatal intervention and to develop efficient, effective and ecologically valid screening and intervention strategies to be used widely.
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            Complicated and Uncomplicated Pregnancies: Women’s Perception of Risk

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              Social support and antenatal depression in extended and nuclear family environments in Turkey: a cross-sectional survey

              Background Social support is strongly implicated in the aetiology of perinatal mental disorder: particularly the quality of the marital and family environment. Family structures are important under-researched potential modifiers. Turkey offers particular advantages for research in this area because of long-standing coexistence of Western and Middle Eastern family structures. We aimed to investigate associations between the quality of key relationships and depression in women in their third trimester of pregnancy, and the extent to which these associations were modified by family structure. Method Women attending antenatal clinics in their third trimester were recruited from urban and rural settings in Ankara. A nuclear family structure was defined as a wife and husband living alone or with their children in the same household, whereas a traditional/extended family structure was defined if another adult was living with the married couple in the same household. Depression was ascertained using the Edinburgh Postnatal Depression Scale (EPDS) and social support was assessed by the Close Person Questionnaire with respect to the husband, mother and mother-in-law. Social support was compared between participants with/without case-level depression on the EPDS in linear regression models adjusted for relevant covariates, then stratified by nuclear/traditional family structure. Results Of 772 women approached, 751 (97.3%) participated and 730 (94.6%) had sufficient data for this analysis. Prevalence of case-level depression was 33.1% and this was associated with lower social support from all three family members but not with traditional/nuclear family structure. The association between depression and lower emotional support from the husband was significantly stronger in traditional compared to nuclear family environments. Conclusions Lower quality of relationships between key family members was strongly associated with third trimester depression. Family structure modified the association but, contrary to expectations, spousal emotional support was a stronger correlate of antenatal depression in traditional rather than nuclear family settings. Previous psychiatric history was not formally ascertained and the temporal relationship between mood state and social support needs to be clarified.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                og
                Revista de Obstetricia y Ginecología de Venezuela
                Rev Obstet Ginecol Venez
                Sociedad de Obstetricia y Ginecología de Venezuela
                0048-7732
                December 2015
                : 75
                : 4
                : 242-249
                Affiliations
                [1 ] Universidad de Los Andes (ULA)
                [2 ] Universidad de Los Andes (ULA)
                [3 ] Universidad de Los Andes (ULA)
                Article
                S0048-77322015000400004
                c07ad7bf-2da7-47f3-b247-4d86b4e688c1

                http://creativecommons.org/licenses/by/4.0/

                History
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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0048-7732&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                Estrés percibido,Embarazo,Alfa amilasa salival,Stress perception,Pregnancy,Alpha amylase enzyme

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