ABSTRACT
The objective of this study was to evaluate the relationship between psychosocial stress in pregnancy and negative perinatal outcomes and to identify key moderators of this relationship. To evaluate this relationship, a meta-analytic review was conducted of studies that prospectively assessed the relationship between psychosocial stress in pregnancy and perinatal outcomes. A total of 35 studies, written or published between 1991 and 2009, involving 31,323 women were located. The overall association between psychosocial stress and negative perinatal outcomes was significant, but negligibly small in size (r (35)â=â-0.04, CIâ=â-0.08, -0.01). Examining specific perinatal outcomes, only the associations with neonatal weight (r (14)â=â-0.07, CIâ=â-0.03, -0.01) and risk for low birth weight (r (5)â=â0.07, CIâ=â0.03, 0.10) were statistically significant, but again, very small. Results support that psychosocial stress explains a negligible to very small amount of the variability in perinatal outcomes. Future research should focus on identifying other psychosocial and lifestyle variables that alone or in interaction with other factors explain larger amounts of the variability in perinatal outcomes. Future research should also examine whether psychosocial stress increases risk for negative outcomes in combination with other biomedical and psychosocial risk factors.
Subject(s)
Fetal Growth Retardation , Pregnancy Complications , Pregnancy Trimester, Third/psychology , Stress, Psychological , Female , Fetal Growth Retardation/etiology , Fetal Growth Retardation/physiopathology , Fetal Growth Retardation/psychology , Humans , Infant, Low Birth Weight/psychology , Infant, Newborn , Life Change Events , Pregnancy , Pregnancy Complications/etiology , Pregnancy Complications/physiopathology , Pregnancy Complications/psychology , Pregnancy Outcome/psychology , Risk Factors , Stress, Psychological/complications , Stress, Psychological/physiopathology , Stress, Psychological/psychologyABSTRACT
PURPOSE: New, highly efficient technologies used in genomic analysis are described, and their implications for health care are discussed. SUMMARY: The availability of the human genome sequence, in confluence with the ability to affordably package it for analysis, is opening new frontiers in biomedical research. On the horizon, personalized medicine--driven by molecular characterization of disease, genetic analysis of the patient, and information technologies designed to enable health care professionals to leverage these tools--promises to fundamentally transform health care. New genetics technologies, such as high-density microarrays, will fuel this research by providing researchers with the ability to comprehensively access the human genome in all its complexity. Some of the most promising areas for application of genetic information are those where society's current needs are greatest: complex, common disorders, such as cancer and cardiovascular disease; drug interactions; inherited genetic disorders that afflict children; and late-onset conditions for which no cure currently exists. The barriers to using genetic information widely in health care are in many cases not technological or economic, but social and political. CONCLUSION: New technology enables efficient, large-scale analysis of the whole genome, genetic variations, and gene expression. Genomic analysis has profound clinical, economic, and social implications for health care.