Mastery Impacts Physiologic Variables and Perinatal Outcomes

Purposes: The purposes were 1) to explore the effect of level of mastery with obesity and gestational weight gain on heart period (HP), respiratory sinus arrhythmia (RSA), oxy-hemoglobin (HbO₂), peripheral oxygenation (SpO₂), hemoglobin _A1c (Hb_A1c), systolic blood pressure (SBP), and hemoglobin F (HbF) and 2) to determine if there is an association between the level of mastery and the frequency of adverse perinatal outcomes in low risk pregnant woman with varied body mass index (obese and not-obese).

 Methods: This is a secondary analysis of data of an observational study of  41 pregnant women  at three time points: 20, 28, and 36 weeks’ gestation. Data were organized according to the mean mastery level at 20 weeks gestation, with obesity (obese and non-obese), and gestational weight gain (using the Institute of Medicine’s recommendation for weight gain). Repeated measures data were analyzed by the general linear model (GLM) to test for group differences and changes over time.

 Results: There were significant changes over time for HP, RSA, HbO₂ and HbA_1c. Changes over time of HbO₂ were different between obese and non-obese women. Obese women with the lower mastery levels had higher SBP at 20 and 28 weeks than the other women. Obese and non-obese women with lower mastery levels had lower HbF at 20 weeks. Women with excess weight gain had lower RSA at 20 and 36 weeks. Non-obese women had more frequent episodes of hypertension and postpartal bleeding than non-obese women with higher mastery levels. There were no significant findings in the frequency of perinatal outcomes for obese women.

 Conclusion: The findings suggest that the effect of the mastery level on physiologic variables may be different for obese and non-obese women. However, further research is needed before mastery levels can be used as a marker for altered adaptation in pregnancy.