[Truncated] Introduction: Psychological stress experienced by women during pregnancy may adversely impact on fetal growth and development and has been linked to poor birth outcomes including small for gestational age and preterm birth. One of the proposed biological mechanisms is that poor mental health such as depression or anxiety symptoms in pregnancy may cause a reduction in placental and fetal blood supply. This concept forms the focus of this thesis. Published human studies using Doppler ultrasound have not convincingly proven this hypothesis to date. The examination of the impact of antenatal mental health on the intrauterine environment requires longitudinal assessment over time, a large cohort of pregnant women representative of the general population and adequate measurement and control for confounding variables. This thesis has examined this theory by standard and two novel methodological approaches specifically:
1. By including the quantitative assessment of the blood flow volume in the umbilical vein as a direct physiological representation of fetal blood supply.
2. By including the assessment of the woman’s own adverse or stressful early childhood experiences.
Methods: In a prospective longitudinal study of 136 low risk singleton pregnancies from the Peel Child Health Study cohort in Western Australia, three ultrasound examinations were performed at 18, 26 and 34 weeks of gestation. The ultrasound assessments included: Serial measures of fetal biometry; Doppler measurement of blood flow in the maternal uterine arteries, the umbilical artery and the fetal middle cerebral artery; The quantitative assessment of the umbilical venous flow in the intra-amniotic portion of the umbilical cord.
|Qualification||Doctor of Philosophy|
|Publication status||Unpublished - 2015|