Influences Of Mental Health Level And Dietary Exposure During Pregnancy On Neonatal Blood Pressure

Objective:To investigate the influences of mental health level and dietary exposure during pregnancy on newborn blood pressure and select the influencing factors of neonatal blood pressure, so as to provide basic information for establishment of intervention methods to promote perinatal health care quality of pregnant women and prevent hypertension in adult stage.Methods:Pregnant women and the newborns were chosen by cluster sampling from July2010to December2010in Anqing municipal hospital. Two hundreds and ten study objects were investigated according to inclusion criteria and exclusion criteria with informed consent.210questionnaires were delivered and206objects with integrate data were analyzed. Use self-designed Pregnant Women Health Condition Questionnaire, general demographic characteristics and related information of pregnant women were collected, as well as dietary specialty and food preference during pregnancy were recorded. Pregnant women were asked to fill out The Symptom Checklist90(SCL-90). Delivery situation and birth outcome data of neonates were recorded. Blood pressures of newborns were measured from4hours to48hours after born.All the data were organized by specially-assigned people, logged in with Epidata3.1, and statistically analyzed by SPSS13.0software. Independent sample t-test, analysis of variance, non-parametric test, rank correlation analysis, and Logistic regression model were used for statistical analysis. Results:Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) of newborns were abnormal distributed. Blood pressures between male and female neonates were basically close, with no significant difference of neonatal blood pressure between different sexes. There are no statistical associations between gestational SBP, DBP and neonatal SBP, DBP.Neonatal SBP was highest in the appropriate maternal age group, then the advance maternal age group, while the young maternal age group had the lowest neonatal SBP; neonatal DBP was elevated along with pregnant age, which was highest among advance maternal age group, while there was no statistical significance.Neonatal SBP among different maternal educational level showed statistic difference(x2=9.76, P=0.02):neonates from less than primary school and primary school group had the lowest SBP, followed by the high school and technical secondary school group, then junior high school group, and the SBP was highest in junior college and above group. As for neonatal DBP, high school and technical secondary school group was the lowest, junior college and above group was the second lowest, junior high school group was higher, while less than primary school and primary school group was the highest, but no statistic difference was observed.Neonatal SBP and DBP showed difference among different household per capita income group, yet not statistically significant. Newborn DBP was lowest in high household per capita expenditure group, then the low household per capita expenditure group, whereas DBP in the middle household per capita expenditure group was the highest, with significant difference (x2=7.37, P=0.03). Newborn DBP in different household per capita expenditure groups varied similarly to SBP however, there was no statistical significance.Influence of family harmony on newborn SBP and DBP was minor; newborn SBP in mothers with mood swing group was higher than mothers without mood swing group; SBP and DBP were higher in smoking family group and caesarean section group than non-smoking family group and spontaneous labor group respectively, while there was no statistical significance between these groups.The average total score of SCL-90and symptom factor score were compared with norm in China, showing seven factors including obsession, interpersonal sensitivity, depression, anxiety, hostility, paranoia, and psychotism were lower than norm with statistical difference(P<0.05), whereas somatization and terror were similar to norm. Pregnant women living in rural areas had both higher SCL-90total score and9symptom factor score, among which the depression factors and terror factors showed statistical differences (P=0.01).No significant difference of SCL-90total score and symptom factor score was observed among pregnant women with different ages, educational level, household per capita income, household per capita expenditures, and family harmony status.Newborn SBP and DBP in SCL-90total score>160group was lower than<160group, yet with no statistical significance. Somatization factor positive group had higher newborn SBP than the negative group, whereas the DBP between the two groups were close. Lower neonatal SBP and DBP occurred in obsession, interpersonal sensitivity, depression, anxiety, hostility, terror, paranoia, and psychosis factor positive groups, among which neonatal SBP was significant (P=0.03) lower in depression factor positive group while neonatal DBP was significant (P<0.05) lower in interpersonal sensitivity, hostility, terror factor positive groups. In dietary exposure during pregnancy no significant difference was shown in terms of meat, egg, carrot and green vegetable and self-estimated salt intake. Newborn SBP and DBP were lower when mothers had little pickles diet, while the SBP was significant lower (x2=4.15, P=0.04)。Binary logistic regression analysis showed that the influencing factors for neonatal SBP were maternal educational level (x2=5.121, P=0.024) and depression factor (^2=6.244, P=0.012); influencing factors for neonatal DBP were interpersonal sensitivity factor (x2=5.058, P=0.025), depression factor (x2=4.414, P=0.036), hostility factor (x2=4.568,P=0.033), terror factor (x2=9.364,P=0.002), and pickles diet (x2=4.297, P=0.038)Multiple logistic regression analysis indicated that education level and the depression factor of pregnant women were correlated with the neonatal diastolic blood pressure. The educational level is a protective factor for decreasing newborn systolic blood pressure, while the depression factor is a risk factor; the terror factor is a risk factor for increasing neonatal diastolic blood pressure.Conclusions:The maternal educational level, the household per capita expenditure, pickles diet, mental health level including interpersonal sensitivity factor, depression factor, hostility factor, and terror factor can impact neonatal blood pressure; while there is little impact on neonatal blood pressure as for maternal age, household per capita incomes, mood swings, delivery pattern, family harmony, family smoking, newborn gender, dietary exposure about meat, egg, carrot, vegetable, and the self-estimated salt intake, the mental health level SCL-90total score, somatization, obsession, anxiety, paranoid, and psychosis factor. Attention should be paid to the influence of multiple factors on neonatal blood pressure during pregnancy, providing interventions at appropriate time and strengthening health care in perinatal period.