Allostatic Load And Its Influencing Factors In Pregnant Women At Different Trimesters

Objective To describe the trends of allostatic load throughout pregnancy,compare the differences of social economic,psychological and behavioral factors between high and low allostatic load groups at≤14 weeks of gestation,23～27 weeks of gestation and30～34 weeks of gestation,and explore the influencing factors of allostatic load in pregnant women.Methods This study was a longitudinal study.Pregnant women who met the inclusion and exclusion criteria were investigated from a maternal and child health hospital and the obstetrics clinic of a 3a grade hospital in Anhui Province from November 2021 to November 2022,respectively.After informed consent of pregnant women,questionnaire survey,physical examination and laboratory examination were conducted at≤14 weeks of gestation,23～27 weeks of gestation and 30～34 weeks of gestation to evaluate the allostatic load level at different trimesters and its influencing factors in pregnant women.Prenatal depression was assessed by Edinburgh Postnatal Depression Scale(EPDS).The International Physical Activity Questionnaire-Short Form(IPAQ-SF)was used to assess the level of physical activity.The visual analogue scale was used to evaluate the degree of fatigue.Sleep duration was investigated.Physical examination included height,weight,blood pressure and waist circumference.Laboratory examination included total cholesterol,high-density lipoprotein,blood glucose,high-sensitivity C-reactive protein.SPPS 24.0 software was used for statistical analysis.Repeated measures ANOVA and pairwise comparison(LSD)were used to analyze the trends of allostatic load and its markers.Independent sample t test,X~2 test or continuous correction ofX~2 test were used to analyze the influencing factors of allostatic load.The variables with statistical significance in the univariate analysis were included in the generalized estimating equation model to analyze the influencing factors of allostatic load during pregnancy.Results A total of 152 pregnant women with an average age of(29.64±4.49)years were included in this study.The total score of allostatic load was 0～8.There were34.0%,35.3%and 32.7%pregnant women in the high allostatic load group at≤14weeks,23～27 weeks and 30～34 weeks,respectively(total scores of allostatic load≥3points),and the mean values of allostatic load were(2.06±1.68),(2.07±1.84)and(2.07±1.68)points,respectively.The biomarkers of allostatic load showed significant differences in different periods of pregnancy(all P<0.05).The results of generalized estimating equation showed that compared with the unemployed pregnant women,the risk of office staff(OR=0.349,95%CI=0.138-0.884,P=0.026),professional and technical personnel(OR=0.337,95%CI=0.134-0.845,P=0.020)were less likely to be in the high allostatic load group.Depression(OR=2.336,95%CI=1.025-5.323,P=0.044)was risk factor of allostatic load during pregnancy.Sleep duration over 9 hours(OR=0.602,95%CI=0.408-0.889,P=0.011)was a protective factor for allostatic load during pregnancy.Conclusions Pregnancy itself is a chronic stressor,and pregnant women have a high allostatic load levels at different trimesters.The biomarkers of allostatic load change dynamically during pregnancy.The allostatic load of pregnant women is affected by occupational,psychological and behavioral factors.Paying attention to occupational inequality and improving depression and sleep status during pregnancy will be helpful to reduce the chronic‘wear and tear’of pregnant women’s physiological system and promote maternal and infant health.