Salivary alpha-amylase as an indicator of stress in pregnant women


Cite item

Full Text

Abstract

Acute or chronic stress during pregnancy and before spinal anesthesia (SA) for cesarean section (SC) causes poor birth outcomes. So it seems important to find objective and non-invasive measure of stress intensity in order to predict and prevent adverse events during labor. The goal of the study was to develop non-invasive and accessible method for objective estimating of stress presence and intensity. Material and Methods. Prospective observational study was conduced in order to estimate significance and magnitude of changing of salivary a-amylase level (AAC) in pregnant woman before and after SC performed under SA and to study its relationship with stress intensity. The study included 30 women, 20-41 years old, full-term pregnancy, undergoing CS under SA. Saliva sampling was followed by registering of patient's estimate of current stress intensity, from 0 (no stress) to 3 (intensive stress). AAC (ME/l) was defined using automatic biochemical analyzer Labio 200 (Mindray). The saliva sampling and stress intensity estimating was performed 3 times: at baseline (in the ward after admission), on the operating table immediately before performing of SA and during 1st hour after delivery. Data analysis included descriptive statistics, ANOVA and c2 -criteria. Results. The AAC mean values differ significantly among 3 sampling points. The AAC mean after CS was lower than before labour but didn't equal baseline level. The highest mean of patient's estimate of current stress intensity was revealed before CS. The higher AAC value corresponds to the higher grade of patient's stress intensity estimate. The results of our study supposed non-linear relationship between AAC and VAS estimation of postoperative pain. Conclusion. The AAC has relationship with stress intensity and postoperative VAS estimate in pregnant women undergoing CS under SA. This biomarker is simple objective and non-invasive measure of the patient’s stress intensity before delivery and postpartum. Further clinical studies are required to enhance proposed method of objective and non-invasive estimation of stress intensity in before labor and postpartum.

About the authors

Evgeniy N. Degtyarev

Amur Regional Clinical Hospital

Email: dormicumtrade@gmail.com
MD, physician of the Department of anesthesiology and intensive care at maternity obstetric service, Amur Regional Clinical Hospital, Regional Perinatal Centre 675028, Blagoveshchensk, Russian Federation

E. M Shifman

M.F. Vladimirsky Moscow Regional Research and Clinical Institute

129110, Moscow, Russian Federation

G. P Tikhova

Petrozavodsk State University

185910, Petrozavodsk, Russian Federation

References

  1. Talge N.M., Neal C., Glover V. Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J. Child Psychol. Psychiatry. 2007; 48:245-61.
  2. Alder J., Fink N., Bitzer J., Hosli I., Holzgreve W. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J. Matern. Fetal Neonatal. Med. 2007; 20:189-209.
  3. Martini J., Knappe S., Beesdo-Baum K., Lieb R., Wittchen H.U. Anxiety disorders before birth and self-perceived distress during pregnancy: associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Hum. Dev. 2010; 86:305-10.
  4. Hanss R., Bein B., Francksen H. et al. Heart rate variability-guided prophylactic treatment of severe hypotension after subarachnoid block for elective caesarean delivery. Anesthesiology. 2006; 104:635-43.
  5. Hanss R., Bein B., Weseloh H. et al. Heart rate variability predicts severe hypotension after spinal anesthesia. Anesthesiology. 2006; 104:537-45.
  6. Spielberger C.D., Gorsuch R.L., Lushene R.E. et al. Manual for the State-Trait Anxiety Inventory (STAI) form Y. Palo Alto. CA: Consulting Psychologists Press Inc.; 1983.
  7. Gregg M.E., James J.E., Matyas T.A., Thorsteinsson E.B. Hemodynamic profile of stress-induced anticipation and recovery. Int. J. Psychophysiol. 1999; 34:147-62.
  8. Leighton B.L., Norris M.C., DeSimone C.A., Darby M.J., Menduke H. Pre-eclamptic and healthy term pregnant patients have different chronotropic responses to isoproterenol. Anesthesiology. 1990; 72:392-3.
  9. Nater U.M., La Marca R., Florin L.et al. Stress-induced changes in human salivary alpha-amylase activity - associations with adrenergic activity. Psychoneuroendocrinology. 2006; 31:49-58.
  10. Chatterton Jr. R.T., Vogelsong K.M., Lu Y.C., Ellman A.B., Hudgens G.A. Salivary alpha-amylase as a measure of endogenous adrenergic activity. Clin. Physiol. 1996; 16:433-48.
  11. Chatterton Jr. R.T., Vogelsong K.M., Lu Y.C., Hudgens G.A. Hormonal responses to psychological stress in men preparing for skydiving. J. Clin. Endocrinol. Metab. 1997; 82:2503-9.
  12. Noto Y., Sato T., Kudo M., Kurata K., Hirota K. The relationship between salivary biomarkers and state-trait anxiety inventory score under mental arithmetic stress: a pilot study. Anesth. Analg. 2005; 101:1873-6.
  13. Takai N., Yamaguchi M., Aragaki T., Eto K., Uchihashi K., Nishikawa Y. Effect of psychological stress on the salivary cortisol and amylase levels in healthy young adults. Arch. Oral Biol. 2004; 49:963-8.
  14. Rohleder N., Wolf J.M., Maldonado E.F., Kirschbaum C. The psychosocial stress-induced increase in salivary alpha-amylase is independent of saliva flow rate. Psychophysiology. 2006; 43: 645-52.
  15. Guglielminotti J., Dehoux M., Mentre F., Bedairia E., Montravers P., Desmonts J.-M., Longroisa D. Assessment of salivary amylase as a stress biomarker in pregnant patients. International Journal of Obstetric Anesthesia. 2012; 21:35-39.
  16. Hanss R., Bein B., Ledowski T. et al. Heart rate variability predicts severe hypotension after spinal anesthesia for elective caesarean delivery. Anesthesiology. 2005; 102:1086-93.

Copyright (c) 2017 Eco-Vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies