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McKee KS , Seplaki C , Fisher S , Groth SW , Fernandez ID
Cumulative Physiologic Dysfunction and Pregnancy: Characterization and Association with Birth Outcomes
Matern Child Health J. 2017 Jan;21(1) :147-155
PMID: 27439420    PMCID: PMC5389895    URL: https://www.ncbi.nlm.nih.gov/pubmed/27439420
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Objective To characterize cumulative physiologic dysfunction (CPD) in pregnancy as a measure of the biological effects of chronic stress and to examine its associations with gestational age and birth weight. Methods Women </=28 weeks gestation were enrolled from obstetric clinics in Rochester, NY and followed through their delivery. CPD parameters included total cholesterol, Interleukin 6 (IL-6), high sensitivity-C-reactive protein (hs-CRP), systolic and diastolic blood pressure, body mass index at <14 weeks gestation, glucose tolerance, and urinary albumin collected in the third trimester. Linear regression was used to estimate the association between physiologic dysfunction and birth weight and gestational age, respectively (N = 111). Results CPD scores ranged from 0 to 6, out of a total of 8 parameters (Mean 2.09; SD = 1.42). Three-fourths of the participants had a CPD score of 3.0 or lower. The mean birth weight was 3397 g (SD = 522.89), and the mean gestational age was 39.64 weeks (SD = 1.08). CPD was not significantly associated with either birth weight or gestational age (p = 0.42 and p = 0.44, respectively). Conclusion CPD measured at >28 weeks was not associated with birth weight or gestational age. Refinement of a CPD score for pregnancy is needed, taking into consideration both the component parameters and clinical and pre-clinical cut-points for risk scoring.
McKee, Kimberly Schmitt Seplaki, Christopher Fisher, Susan Groth, Susan W Fernandez, I Diana eng K01 AG031332/AG/NIA NIH HHS/ T32 HL007937/HL/NHLBI NIH HHS/ U01 HL096760/HL/NHLBI NIH HHS/ 2016/07/22 06:00 Matern Child Health J. 2017 Jan;21(1):147-155. doi: 10.1007/s10995-016-2103-0.