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PRETERM

Preterm and behavior


Unhealthy lifestyle

Violation during
alcohol smoking Drug abuse
pregnancy

Caused

Increased genitalia Placenta Increased levels of


tract infections vasoconstriction catecholamines

Preterm Labor
Preterm and Psychobiological
Over-activation Fluctuation Stimulation
Maternal stress, • Sympathis nervous • Sympathetic system hypothalamic-
depression, anxiety • Vascular contraction • Imunne system pituitary-adrenal
• Neurpendocrine system • Cardiovascular system axis(HPA)

Released
Stimulate fetal
Increased levels of • Cortisol Increased allostatic
hormonal activity
placental CRH • Corticotrophim-releasing load
prematurely hormone

Preterm labor and Fetal morbidity or


delivery mortality
Psychosocial, Biological, and
Behavioral model
Acute stress
•Pregnancy-related anxiety
•Emotional states anxiety, depression Pretem Birth

Sterr reactivity

Mother Chronic
•Race/athn city stress
Stress realited
pregnancy
Health risk behaviors medical
condiions

Allostatic load
measure
Stressors

Induvidual Level Sociocultureal Level

Chronic stressors

Relationship level Community Level


Cortisol and Preterm Labor
Production of Increasing Gap
Cortisol Prostaglandines Juction between
(PGs) uterine cells

Inhibition of Genital tract matrix


Enchance
myometrial metallo-
myometrial oxytocin
progesterone protases(MMPs)
receptors formation
receptor expression release

Production of
Increase of CAPs Preterm Labor
estrogens
Consequence
long-term
Prenatal death neurological Exorbitant costs
disorders

Respiratory,
Immune
gastrointestinal Cerebral palsy
problems
and renal problem

Mental
retardation
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