I found this article in a medical journal called News-Medical.net

Warnings signs such as increased stress could indicate that pregnancy-induced hypertension is reaching life-threatening levels, found Temple University researcher Kathleen Black, DNSc, RNC, the author of a study in the September/October issue of the Journal of Obstetric, Gynecologic, & Neonatal Nursing.
"The condition is variable and can change quickly. We need to be aware of symptoms changing from mild to worse. A higher number of symptoms could also mean [pregnancy-induced hypertension] is getting worse," Black said.

Also known as preeclampsia and gestational hypertension, pregnancy-induced hypertension occurs at about 20 weeks in 6 percent to 8 percent of pregnancies. The exact cause is not known. Severe forms of these conditions can play a role in perinatal developmental issues of the fetus or even death for both the mother and fetus. The perinatal period is defined as the time of birth (five months before and one month after).

Women should call their physician if they're experiencing headaches, dizziness, frequent vomiting and malaise, Black said.

Usually, the blood vessels expand during pregnancy to increase blood flow, but high blood pressure causes them to clamp down, Black explained.

Nurses currently monitor the condition on an outpatient basis by checking in regularly with their patients. They generally look for the symptoms of persistent headache, blurred vision and abdominal pain as signs that it could be getting worse. In the study, Black suggests also assessing for other symptoms such as perceived stress, vertigo, inability to concentrate and mental changes.

Women become hospitalized and could deliver early if the condition is either severe or getting worse.

"Right now, the 'cure' in severe cases is delivery, which could mean a premature baby. If it stays mild, the pregnancy can still go smoothly," Black said.

Philadelphia resident Michelle Murphy-Rosanski delivered five weeks early in October 2003 because her preeclampsia became too severe. She suffered from a persistent headache, more than usual weight gain and sound sensitivity with the condition.

"I'm so glad my daughter and I are doing well. It was very frightening, you kept wondering if the baby was OK," said Murphy-Rosanski, who is a nursing instructor. "All these things are going on with your body, and you don't know what to about it."

Gestational hypertension is diagnosed when there is high blood pressure without protein in the urine. Preeclampsia is more serious than gestational hypertension, where the kidney leaks protein. Preeclampsia can affect many organs and cause serious or even life-threatening problems.

Black became interested in studying the condition while working as a perinatal nurse for high-risk pregnancies and a labor and as a delivery nurse for more than 25 years.

"I followed women with mild preeclampsia and saw their condition go from mild to severe within a few days. We want nurses to catch the symptoms as soon as possible. I wanted to see if there was a trigger for this," she said.

In her study, Black found that stress is higher in women with worsening or severe preeclampsia and gestation hypertension. She said nurses can help their patients reduce stress levels by identifying social supports within the family and in the community, or bringing in a home nurse if needed. Women with mild preeclampsia should slow down their activities.

"We can give emotional support just by simply listening to them," Black said.

Murphy-Rosanski said a home help nurse and her midwife helped her through the stressful situation. She also made sure her family understood the condition.

"It's important everyone around you knows what's going on. It's not something that you did wrong to make it happen," Murphy-Rosanski added.

Based on this research, Black is developing a comprehensive tool for all nurses to monitor the condition and to assist women in coping with it.

"As nurses, we take a holistic approach to this issue by addressing the psychological and physical needs of the patient," Black said.

http://www.temple.edu/

Here is an article that links Anxiety to premature birth.

Women who are particularly anxious about their pregnancy may be at increased risk of premature delivery, a new study suggests.
Researchers found that among 1,820 pregnant women, those with the greatest concerns about their pregnancy were nearly three times more likely than those with the least anxiety to deliver prematurely. The findings are published in the journal Psychosomatic Medicine.
Stress during pregnancy has been linked to a higher risk of complications in some studies, though not all. And those that have identified a link have not suggested any simple solutions to the problem.
For the current study, researchers looked specifically at women's worries related to their pregnancy — including anxiety over labor and delivery, and worries about early pregnancy problems like bleeding and nausea. The goal was to see whether the risk of preterm birth was influenced by the types of anxiety that obstetricians can fairly easily address.
For example, a woman's fears about labor might be allayed by a thorough discussion with her doctor, according to the study authors, led by Dr. Suezanne T. Orr of East Carolina University in Greenville, North Carolina.
For their study, the researchers had 1,820 women complete a questionnaire on pregnancy worries during their first visit for prenatal care. The women were asked whether they were anxious about labor and delivery, the health of the baby, nausea, and pain or bleeding during early pregnancy.
They were then given anxiety "scores" ranging from 0 to 6.
Overall, Orr's team found, women who scored a 5 or 6 were at greater risk of preterm delivery than those with lower scores. This remained true when the researchers considered factors that could both fuel women's anxiety and raise the risk of preterm birth — such as a history of problems in past pregnancies, or health problems during the current pregnancy.
The findings suggest that excessive anxiety itself may contribute to premature delivery in some women, according to Orr and her colleagues.
"If additional research confirms our findings," they write, "then this might suggest an avenue for intervention to reduce spontaneous preterm birth. Anxiety is a treatable condition."
They point out that pregnancy-related worries, in particular, can be addressed with education.
"Pregnant women could receive information from their healthcare providers about the signs and symptoms of a normal pregnancy and the process of labor and delivery to reduce their worries and concerns about pregnancy, and ultimately their risk of spontaneous preterm birth outcomes," the team notes.
SOURCE: Psychosomatic Medicine, July/August.

London, June 2:

British scientists have found that long-term stress experienced by mothers during pregnancy adversely affects their unborn babies.

Researchers led by Vivette Glover at London's Imperial College studied 267 women, taking a blood sample from the mother and a sample from the amniotic fluid surrounding the baby.

They measured levels of a stress hormone called cortisol in both samples. At the age of 17 weeks and older, they found the higher the level of cortisol in the mother's blood, the greater the level of cortisol in the amniotic fluid, said a report published Thursday in the British Journal of Clinical Endocrinology.

"This is an important study as for the first time, there is solid evidence to show that an unborn child may be exposed to maternal stress as early as 17 weeks in development," the scientists said.

Amniotic fluid is a protective fluid that surrounds the foetus and reflects the exposure of the unborn child to various substances including hormones.

Stress hormones were a reaction to anxiety and useful in the short term because they helped the body deal with stressful situations, the online
edition of BBC News reported.

However, if the stress goes on for a long time, the hormones can affect people's health leading to tiredness, depression and illness, a scientist involved in the study said.

This in turn can lead to health problems such as headaches, upset stomach, Rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke.

"We now need to carry out further work to unravel the mechanisms by which maternal stress affects the foetus, both during foetal life and into childhood," the scientist added.

Previous studies have suggested stress hormones activated by maternal anxiety may have a long-term effect on the child's brain development and future behaviour.

It had found babies exposed to the highest levels of cortisol while in the womb had lower intelligent quotients (IQ) at 18 months, compared with the infants of mothers who were less stressed.

Studies have also shown that children of highly stressed and anxious pregnant women were at double the risk of hyperactivity and attention deficit hyperactivity disorder (ADHD) at the age of four.

"For now, based on previous research, one thing is clear - high levels of stress in pregnancy can, in some cases, be detrimental to the health of the baby," scientists said after the latest study was published.

"To remain as stress-free as possible is certainly important during pregnancy. Of course, this is easier said than done as pregnancy itself can incite all sorts of feelings like feeling overwhelmed, happy and nervous," the study said.

Pregnancy can signify major emotional changes in mums-to-be, from mood swings to feeling incredibly anxious, which may well elevate women's stress levels. However, scientists said it is vital that pregnant women are given adequate Support and reassurance from their family, friends and employers, to ensure they have a happy and healthy pregnancy.

This article was taken from Mangalorean News